[Anatomical and clinical study on the femoral nerve lesion].
Neuralgic and paralytic symptoms due to lesions of the femoral nerve or its related nerve roots are not infrequently encountered and therefore, clinically important. In order to clarify their pathomechanism the author has done anatomical, kinesiologic, and clinical studies. The topographic course of the femoral nerve was carefully observed in 40 cadavers (80 nerves) and transverse sections of 4 cadavers cut horizontally at various levels. The interrelation between the nerve and its surrounding organs was thus analysed. The 81 cases (87 nerves) of femoral nerve lesion, including lumbar radiculopathy, femoral neuropathy, and saphenous nerve lesion, were clinically followed up and the mechanism of their production was analysed. Besides, kinesiologic studies using electromyograms of the trunk and lower extremity muscles were performed in 8 cases (9 lesions) and 20 normal male controls. The main results obtained are as follows: 1. From the embryologic and morphologic points of view, the femoral nerve runs a peculiar course and has characteristic shapes in its transverse sections at various levels. 2. As the nerve lies closely adjacent to several pelvic organs, it can easily be influenced by their pathological conditions. 3. When the adjacent organs are treated surgically, it may be rare that the nerve is injured, constituting a complication. 4. The pathomechanism of the femoral neuropathy occurring at the inguinal ligament is quite similar to that of entrapment neuropathy of the peripheral nerve that occurs at a fibro-osseous tunnel. 5. Even if the quadriceps femoris muscle is totally paralysed, extention of the knee joint is possible to some extent because of a compensatory action of the tensor fasciae latae muscle.
D000328:Adult; D004576:Electromyography; D005267:Femoral Nerve / Q000033:anatomy & histology* / Q000473:pathology; D005269:Femur; D006801:Humans; D008297:Male; D009132:Muscles / Q000502:physiology; D009437:Neuralgia / Q000209:etiology; D011129:Polyradiculoneuropathy / Q000209:etiology; D013118:Spinal Cord Diseases / Q000473:pathology