Osteopathy Journals and Research by Darren Chandler

 

Lateral femoral cutaneous nerve entrapment

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Fine architecture of the fascial planes around the lateral femoral cutaneous nerve at its pelvic exit: an epoxy sheet plastination and confocal microscopy study (2018). Xu Z, Tu LZheng YMa XZhang HZhang M. 

The Lateral Femoral Cutaneous Nerve exits the pelvis via a tendinous canal within the internal oblique-iliac fascia septum. This canal may make the Lateral Femoral Cutaneous Nerve susceptible to mechanical entrapment near the ASIS.

The nerve then runs in an adipose compartment between the sartorius and iliolata ligaments inferior to the ASIS.

The iliolata ligaments are a newly defined term in this study describing 2-3 curtain strip-like structures which attach to the ASIS superiorly and are interwoven with the fascia lata inferomedially, being continued laterally as skin ligaments anchoring to the skin.

Between the sartorius and tensor fasciae latae, the Lateral Femoral Cutaneous Nerves runs in a longitudinal ligamental canal bordered by the iliolata ligaments. 

Putzer et al (2017) noted dense fascial fibers after dissecting the interval between the tensor fascia lata, sartorius, and rectus femoris. They described a strong band of fibers extending from a proximal-lateral to distal-medial direction. Henry (1957) possibly described these same fascial webs that are found in the layers that occupy “the space between the origins of the rectus femoris and tensor fasciae [lata] muscles, uniting the deep aspects of their sheaths”. 

Could the Lateral Femoral Cutaneous Nerve also be entrapped in the dense fascia between the tensor fascia lata and sartorius?

References

The deep layer of the tractus iliotibialis and its relevance when using the direct anterior approach in total hip arthroplasty: a cadaver study (2017). David Putzer, Matthias Haselbacher, Romed Hörmann, Günter Klima, and Michael Nogler

Extensile Exposure. 2nd ed. (1957). Henry AK. pp. 209–210.

 

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