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Blocks of Nerves of the Lumbar Plexus Supplying the Lower Extremities
Published in Bernard J. Dalens, Jean-Pierre Monnet, Yves Harmand, Pediatric Regional Anesthesia, 2019
Bernard J. Dalens, Jean-Pierre Monnet, Yves Harmand
The obturator nerve is primarily a motor nerve, but it may contribute significant sensory supply to the hip, to the medial aspect of the thigh, to the medial aspect of the femur, and even to the leg (when it provides a twig to the saphenous nerve). Occasionally, an accessory obturator nerve may supply the pectineus muscle and the hip joint.
Advances in slipped upper femoral epiphysis
Published in K. Mohan Iyer, Hip Joint in Adults: Advances and Developments, 2018
Kishan Gokaraju, Nimalan Maruthainar, M. Zahid Saeed
The primary symptom of a SUFE is pain in the groin or around the hip. Similarly to other hip joint pathology, pain may be experienced as referred pain in the ipsilateral thigh or knee, along the distribution of the obturator nerve.
The Liver (LR)
Published in Narda G. Robinson, Interactive Medical Acupuncture Anatomy, 2016
Clinical Relevance: Sites of compression for the anterior division of the obturator nerve occur between pectineus and obturator externus muscles as well as between the adductor longus and brevis. The obturator nerve travels medial to the femoral nerve within the pelvis. Near to where the obturator nerve exits the pelvis through the obturator foramen, it divides into anterior and posterior branches. The anterior branch courses cranial to the obturator externus muscle while the posterior branch courses through it. The anterior division supplies motor innervation to the adductor longus, adductor brevis, pectineus, and gracilis muscles. It also sends sensory supply to the hip joint and medial thigh. The posterior branch supplies the adductor brevis, the adductor magnus, and the obturator externus. It provides sensation to the knee joint as well. Causes of obturator neuropathy include pelvic and acetabular fractures, post-traumatic hematoma, pelvic tumors, obturator hernia, myositis ossificans, penetrating or surgical trauma, and nerve compression by fibrous brands secondary to chronic adductor tendinopathy with osteitis pubis, more common in athletes.
Intraoperative Complications and Conversion to Laparatomy in Gynecologic Robotic Surgery
Published in Journal of Investigative Surgery, 2022
Ayse Filiz Gokmen Karasu, Gürkan Kıran, Fatih Şanlıkan
There was one patient in our cohort that required conversion due to anesthesia and/or hypercapnia complication. In the report by Badawy et al detailing anesthetic complications of robotic surgery, 24 patients (18%) developed hypercapnia defined by the end-tidal Co2 concentration >45 mm H20 [12]. These patients were managed successfully by the anesthesia team and there was no mention of conversion to laparoscopy or laparotomy. In our case series there was one incident of genitofemoral injury and this was encountered during lymphadenectomy. In a report by Nezhat et al, the obturator nerve is described to be inadvertently cut during pelvic lymphadenectomy. The injury was auspiciously repaired with 4-0 polyglactin sutures in 12 minutes [13]. We would also like to underline that besides the aforementioned case of genitofemoral nerve injury, there were no position related upper extremity or lower extremity neuropathies in our study population.
Long-standing groin pain in an elite athlete: usefulness of ultrasound in differential diagnosis and patient education – a case report
Published in European Journal of Physiotherapy, 2018
Kingsley S. R. Dhinakar, Anjanette Cantoria Lacaste
The radiation of pain on the inner thigh along the distribution of obturator nerve may also suggest injury of neurogenic in origin. This can be supported by the reduced muscle activity of left hip adductors on surface EMG findings and physical assessments. The nature of sport participated by the patient and the repetitive stresses placed on the above structures may have contributed to tendinitis. The anterior branch of the obturator nerve can be potentially entrapped by fascia as it traverses the adductor brevis muscle. This may have started as pain of an inflammatory nature and gradually developed to consistent exercise-related pain. Hip adductor-related groin pain may have developed that can potentially lead to fibrosis and adhesion resulting to nerve entrapment.
Successful restoration of knee extension after transferring of the anterior branch of the obturator nerve: a case study
Published in International Journal of Neuroscience, 2022
Mohammadreza Emamhadi, Iraj Aghaei, Sama Noroozi Guilandehi, Roxana Emamhadi, Mohammad Shabani
In supine position, the femoral nerve was exposed with a longitudinal incision lateral to the palpable femoral artery pulse. The rectus femoris and vastus medialis motor branch of the femoral nerve were identified as recipient nerves and then sectioned. The anterior branch of the obturator nerve was identified with a second longitudinal incision that was made in the proximal medial of the thigh (Supplementary material Video 1). Intraoperative nerve stimulation of this donor nerve demonstrated good contraction and then the nerve was cut and transposed subcutaneously to the femoral nerve. End-to-end neurorrhaphy was performed between the donor and recipient branches using 8-0 monofilament sutures under magnification (Figure 1).