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Study of anatomical variation and branching pattern of the femoral nerve in 25 cadavers

Urmila N Pateliya, Rakesh M Rajat, Kanan P Shah, Monica Chudasma, Jitendra Patel.




Abstract

Backgrouns: Femoral nerve is used for nerve block in several surgeries. The knowledge of femoral nerve in thigh is important for anatomist, anesthetics, and surgeons to prevent iatrogenic femoral nerve palsy. We dissected 25 human cadavers to study the anatomy of femoral nerve. We dissected the femoral nerve bilaterally in Anatomy Department of Smt N H L Municipal Medical College, and recorded the branching pattern of femoral nerve with digital photography.

Objective: To highlight the variation in branching pattern of the femoral nerve.

Materials and Methods: We measured the distance from the anterior superior iliac spine (ASIS) to the pubic symphysis bilaterally on each cadaver as an anatomical landmark. We located the femoral nerve through transverse incisions from the ASIS to the pubic symphysis and incisions originating from the midpoint between the ASIS and the pubic symphysis extending longitudinally to the patella. We chose the inguinal ligament as a proximal limitation for dissection of the femoral nerve in the thigh. The distance from the inguinal ligament to the first branching point of the femoral nerve was measured. We traced and dissected all femoral nerve branches to the insertion points.

Result: The mean medial–lateral distance from the ASIS to the pubic symphysis was 14.50 ± 1.34 cm (range 13–16). We found the femoral nerve near the midpoint, 46± 5% from the ASIS. We did not measure in cadaver specimen 5 since bony landmarks were difficult to palpate because of excessive adipose tissue. The distance from the inguinal ligament to the first branching point of the femoral nerve was 1.50 ± 0.47 cm (range 1–2cm).

Conclusion: The anatomy and morphology we observed remained consistent with the established literature, suggesting that our chosen specimens did not differ from the standard population and that we may consider the results representative of the general population.

Key words: Femoral nerve, anatomical variation, branching pattern






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