Type of Article: Original Research
Year: 2016 | Volume 4 | Issue 2 | Page No. 2158-2161
Date of Publication: 30-04-2016
ANATOMICAL VARIATIONS OF ACCESSORY OBTURATOR NERVE: A CADAVERIC STUDY WITH PROPOSED CLINICAL IMPLICATIONS
Archana B.J *1, Nagaraj D.N 2, Pradeep P 3, Lakshmi Prabha Subhash 4.
*1 Assistant Professor, Department of Anatomy, Sri Siddhartha Medical College, Tumkur, Karnataka, India.
2 Professor, Department of Anatomy, Sri Siddhartha Medical College, Tumkur, Karnataka, India.
3 Senior Resident, Department of Orthopaedics, Sri Siddhartha Medical College, Tumkur, Karnataka, India.
4 Professor and Head, Department of Anatomy, Sri Siddhartha Medical College, Tumkur, Karnataka, India.
Address: Dr. Archana B.J, Assistant Professor, Department of Anatomy, Sri Siddhartha Medical College, Tumkur, Karnataka, India.
Background: The accessory obturator nerve arises from the ventral branches of the third and fourth lumbar ventral rami. It is occasionally present in 10% of population. It descends along the medial border of psoas major, crosses the superior pubic ramus and divides into branches supplying the hip joint and pectineus. There is a high degree of variability in its formation. It may arise from the ventral rami of second and third lumbar nerves or second, third and fourth lumbar nerves or from third lumbar nerve alone. Sometimes the accessory obturator nerve is very small and supplies only pectineus. Any branch may be absent. Knowledge of these variations is important for surgeries of hip joint and in evaluation of groin pain.
Aim: The aim of this study was to evaluate the incidence and variation in the formation of accessory obturator nerve and to analyse the variability of the frequency of this nerve, reported in the literature and to discuss its clinical implications.
Materials and Methods: The study was conducted on 25(50 sides) adult human cadavers in Department of Anatomy, Sri Siddhartha Medical College, Tumkur, Karnataka, India by dissection method. The accessory obturator nerve was looked for, bilaterally, and its formation studied. The specimens were numbered and photographed.
Results: The incidence of accessory obturator nerve in this study was 8%. The nerve was seen arising from ventral rami of third and fourth lumbar nerves in 3 cases (6%) and from ventral rami of second and third lumbar nerves in 1 case (2%). Accessory obturator nerve was observed on the right side in 2 cases (4%) and on the left side in 2 cases (4%). The nerve was found in 2% males and 2% females.
Conclusion: The knowledge of anatomy of accessory obturator nerve is important for orthopaedicians to plan an effective hip surgery to relieve coxalgia. Compression of the nerve as it courses over the superior pubic ramus and subsequent neuropathy is a differential diagnostic option in groin pain. High variability in the incidence and formation of this nerve, highlights the importance of a detailed anatomical knowledge of accessory obturator nerve.
KEY WORDS: Accessory Obturator Nerve, Lumbar Ventral Rami, Pectineus, Coxalgia, Hip Joint, Groin Pain.
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Archana B.J, Nagaraj D.N, Pradeep P, Lakshmi Prabha Subhash. ANATOMICAL VARIATIONS OF ACCESSORY OBTURATOR NERVE: A CADAVERIC STUDY WITH PROPOSED CLINICAL IMPLICATIONS. Int J Anat Res 2016;4(2):2158-2161. DOI: 10.16965/ijar.2016.168