Rajani Singh; Shane Tubbs & Mukesh Singla
Femoral neuropathy associated with lower limb is treated by surgical intervention through activation/regeneration/ grafting of nerve fibers by a nerve cuff electrode implant or neuro-prosthesis. These procedures require detailed and precise knowledge of neuro-anatomical variants of the femoral nerve and its fascicular anatomy so that the nerve injury can be investigated and treated more efficiently. The aim of the study is to uncover the variations both in the femoral nerve and its branches, to classify them and to bring out corresponding fascicular anatomy using a hypothesis based on the principle of consistency, continuity and traceability of fascicles. The study was carried out in the Department of Anatomy AIIMS Rishikesh using 13 matched lower limbs (26 femoral nerves) from 13 cadavers. The femoral nerve was exposed in the femoral triangle and traced to the posterior abdominal wall. Variations in the shape, size and course of the femoral nerve and its branches were analyzed. The fascicular arrangement was also conceptualized based on the hypothesis. Seven classes, high division, trunk anomaly, semi-scattered, scattered branching pattern, pectocutaneous, lateral cutaneous nerve of thigh and nerve to sartorius anomalies were detected. The corresponding fascicular organizations were modeled. The seven classes along with corresponding fascicular pattern will be very useful for neurosurgeons, radiologists, anesthetists and anatomists in diagnosis and treatment of femoral neuropathy.
KEY WORDS: Variations of femoral branching pattern; Classification of femoral nerve; Fascicular model; Nerve cuff electrode; Femoral neuropathy.
SINGH, R.; TUBBS, S. & SINGLA, M. Classification and fascicular analysis of variant branching pattern of femoral nerve for microsurgical intervention. A series of thirteen cadavers. Int. J. Morphol., 34(2):561-569, 2016.