Obturator neuropathy - An anatomic perspective

Entrapment of the anterior division of the obturator nerve is a recently de scribed cause of medial groin pain. This anatomic study examines the extrap elvic course of the nerve and related fascia in the adductor region to prov ide an anatomic basis for the syndrome and to aid in surgical treatment. Tw elve anatomic specimen limbs were dissected to document the extrapelvic cou rse of the obturator nerve, the myofascial arrangement, and the vasculature , A thirteenth limb was prepared with intraarterial glycerin to examine the vessels in more detail, A distinct fascial plane was found deep to the add uctor longus and pectineus overlying the anterior division of the obturator nerve. The arterial supply to the adductor muscles is related intimately t o the nerve and its branches, with associated local thickening of the fasci al connective tissue. The relationship between the nerve, vessels, and fasc ia appears sufficient to result in an entrapment syndrome. The anatomic fin dings from this series will help plan the surgical treatment of this condit ion.