Sartorial Branch of Saphenous Nerve: Anatomical Relationship with Bony Landmarks and Great Saphenous Vein
Amornrat Tothonglor, Sithiporn Agthong, Thanasil Huanmanop, Vilai Chentanez
Abstract
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Amornrat Tothonglor, Sithiporn Agthong, Thanasil Huanmanop, Vilai Chentanez
Abstract
Open-access reader
Sartorial branch of saphenous nerve (medial crural cutaneous nerve) originates at the medial side of the knee and descends along the great saphenous vein (GSV) to innervate the medial aspect of the leg.Its anatomy is of concern in surgical procedures and anesthetic block.However, the measurement data related to palpable bony landmarks with comparison between sexes and sides are lacking.Dissection was done in 95 lower limbs from both sexes.We found that the nerve pierced the deep fascia alone in most cases (92.6%).This piercing point was always distal to the adductor tubercle with the distance of 5-6 cm which was 15% of the leg length (the distance between the adductor tubercle and medial malleolus).The nerve was 7 cm medial to the tibial tuberosity.At the mid-level of leg length, the nerve was slightly over 4 cm medial to the anterior tibial margin.The nerve terminally divided 7 cm proximal to the medial malleolus.Furthermore, the anatomical relationship between the nerve and the GSV was highly variable.The nerve was constantly anterior, posterior or deep to the GSV in 8.4%, 15.8% and 2.1%, respectively.Crossing between the two structures was observed in 57.9% of specimens and the distance to the medial malleolus was 18 cm.Symmetry was found in most parameters and significant gender differences were observed in some distances.These results are important for avoiding the sartorial nerve injury and locating the nerve during relevant procedures.
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Sartorial branch of saphenous nerve (medial crural cutaneous nerve) originates at the medial side of the knee and descends along the great saphenous vein (GSV) to innervate the medial aspect of the leg.Its anatomy is of concern in surgical procedures and anesthetic block.However, the measurement data related to palpable bony landmarks with comparison between sexes and sides are lacking.Dissection was done in 95 lower limbs from both sexes.We found that the nerve pierced the deep fascia alone in most cases (92.6%).This piercing point was always distal to the adductor tubercle with the distance of 5-6 cm which was 15% of the leg length (the distance between the adductor tubercle and medial malleolus).The nerve was 7 cm medial to the tibial tuberosity.At the mid-level of leg length, the nerve was slightly over 4 cm medial to the anterior tibial margin.The nerve terminally divided 7 cm proximal to the medial malleolus.Furthermore, the anatomical relationship between the nerve and the GSV was highly variable.The nerve was constantly anterior, posterior or deep to the GSV in 8.4%, 15.8% and 2.1%, respectively.Crossing between the two structures was observed in 57.9% of specimens and the distance to the medial malleolus was 18 cm.Symmetry was found in most parameters and significant gender differences were observed in some distances.These results are important for avoiding the sartorial nerve injury and locating the nerve during relevant procedures.
Key concepts: Medicine, Saphenous nerve, Anatomy, Great saphenous vein, Humanities, Vein, Surgery, Art