Anatomical Variations of the Lateral Femoral Cutaneous Nerve and Iatrogenic Injury After Autologous Bone Grafting From the Iliac Crest

• Published in: Journal of orthopaedic trauma Vol. 29; no. 12; pp. 549 - 553
• Main Authors: den Brave, Paul S, Vas Nunes, Sabine E, Bronkhorst, Maarten W. G A
• Format: Journal Article
• Language: English
• Published: United States Copyright Wolters Kluwer Health, Inc. All rights reserved 01-12-2015
• Subjects: Bone Transplantation - adverse effects; Female; Femoral Nerve - abnormalities; Femoral Nerve - injuries; Humans; Ilium - transplantation; Middle Aged; Peripheral Nerve Injuries - diagnosis; Peripheral Nerve Injuries - etiology; Skin - innervation; Transplantation, Autologous - adverse effects; Treatment Outcome
• ISSN: 0890-5339; 1531-2291
• DOI: 10.1097/BOT.0000000000000401

OBJECTIVE:We describe 2 patients with surgical injury to the lateral femoral cutaneous nerve (LFCN) after bone harvesting from the iliac crest for autologous bone grafting.
DESIGN:A case-series of 2 patients and literature study of all anatomical variants of the LFCN in relation to the anterior superior iliac spine and inguinal ligament.
SETTING:A teaching hospital in The Hague, the Netherlands.
PATIENTS:Two patients with surgical injury to the LFCN after bone harvesting from the iliac crest for autologous bone grafting.
RESULTS:All 9 known anatomical variations of the LFCN in the literature are reviewed, and the importance of these anatomical variations for surgeons and anesthetists is stressed.
CONCLUSIONS:For every trauma, orthopedic, plastic, and cranio-maxillofacial surgeon and anesthesiologist it is important to know the anatomy of the LFCN and its known variations. To prevent injury of the LFCN during bone harvesting, the bone should be harvested 4–5 cm posterior to the anterior superior iliac spine and the incision should be parallel to the iliac crest.
LEVEL OF EVIDENCE:Therapeutic Level V. See Instructions for Authors for a complete description of levels of evidence.