Unusual innervation of the sartorius muscle by the ilioinguinal and femoral nerves with unique arrangement of the lumbar plexus: a case report and clinical implications
Language English Country Germany Media electronic
Document type Journal Article, Case Reports
PubMed
40067394
DOI
10.1007/s00276-025-03604-0
PII: 10.1007/s00276-025-03604-0
Knihovny.cz E-resources
- Keywords
- Ilioinguinal nerve, Lateral femoral cutaneous nerve, Lumbar plexus, Sartorius muscle, Variation,
- MeSH
- Anatomic Variation * MeSH
- Psoas Muscles * innervation MeSH
- Humans MeSH
- Cadaver MeSH
- Femoral Nerve * anatomy & histology abnormalities MeSH
- Lumbosacral Plexus * abnormalities anatomy & histology MeSH
- Check Tag
- Humans MeSH
- Male MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Case Reports MeSH
The sartorius muscle is typically innervated by two branches of the femoral nerve arising from the lumbar plexus. We present an unreported variant where the sartorius muscle was innervated by an accessory branch arising from the ilioinguinal nerve in addition to the proper two branches from the femoral nerve. The iliohypogastric nerve was fused with the ilioinguinal nerve. More proximally, the lumbar plexus also showed unusual arrangement. The anterior branch of the lateral femoral cutaneous nerve arose from the femoral branch of the genitofemoral nerve while the posterior branch arose directly from the second lumbar nerve. The genital branch of the genitofemoral nerve pierced the psoas major muscle more distally than usual, and featured a close proximity with the femoral nerve. Possible variable appearance of these nerves should be kept in mind during several surgical and diagnostic procedures since their iatrogenic or traumatic damage, or their susceptibility to entrapment, pose unpredictable clinical consequences.
Department of Health Studies College of Polytechnics Jihlava Jihlava Czech Republic
Spinal Surgery Unit Oxford University Hospitals NHS Foundation Trust Oxford UK
See more in PubMed
Anatomy Atlases (2025) Anatomy Atlases: A Digital Library of Human Anatomy. Available at https://www.anatomyatlases.org . Accessed 30 Jan
Avsar FM, Sahin M, Arikan BU, Avsar AF, Demirci S, Elhan A (2002) The possibility of nervus ilioinguinalis and nervus iliohypogastricus injury in lower abdominal incisions and effects on hernia formation. J Surg Res 107(2):179–185. https://doi.org/10.1006/jsre.2002.6479 PubMed DOI
Bardeen CR (1906) Development and variation of the nerves and the musculature of the inferior extremity and of the neighboring regions of the trunk. Am J Anat 6:259–390 DOI
Benes M, Zido M, Machac P, Kaiser R, Khadanovich A, Nemcova S, Kunc V, Kachlik D (2024) Variations of the Extrapsoas course of the lumbar plexus with implications for the lateral Transpsoas approach to the lumbar spine: a cadaveric study. Acta Neurochir 166(1):1–12. https://doi.org/10.1007/s00701-024-06216-6 DOI
Brandt L, Albert S, Brandt KL (2022) Meralgia paraesthetica Als lagerungsschaden: Kein voll beherrschbares Risiko. Anaesthesiologie 71(11):858–864. https://doi.org/10.1007/s00101-022-01213-9 PubMed DOI PMC
Clara M (1953) Das nervensystem des menschen, 2nd edn. Barth, Leipzig
Elhessy AH, Alrabai HM, Eltayeby HH, Gesheff MG, Conway JD (2021) Chronic quadriceps tendon rupture reconstruction with sartorius muscle transfer: a report of five cases. Plast Reconstr Surg Glob Open 9(8):e3785. https://doi.org/10.1097/gox.0000000000003785 PubMed DOI PMC
Frohse F, Fränkel M (1913) Die muskeln des menschlichen Beines. In: Bardeleben K (ed) Handbuch der anatomie des Menschen, vol 2/2, Pt 2 B. Fischer, Jena
Haładaj R, Varga I (2024) Sartorius muscle pierced by terminal branches of the lateral femoral cutaneous nerve: A case report with brief clinical commentaries. Transl Res Anat 34:100280. https://doi.org/10.1016/j.tria.2023.100280 DOI
Harney D, Patijn J (2007) Meralgia paresthetica: diagnosis and management strategies. Pain Med 8(8):669–677. https://doi.org/10.1111/j.1526-4637.2006.00227.x PubMed DOI
Hong JP, Lee HB, Chung YK, Kim SW, Tark KC (2003) Coverage of difficult wounds around the knee joint with prefabricated, distally based sartorius muscle flaps. Ann Plast Surg 50(5):484–490. https://doi.org/10.1097/01.sap.0000044146.45427.1b PubMed DOI
Klaassen Z, Marshall E, Tubbs RS, Louis RG Jr, Wartmann CT, Loukas M (2011) Anatomy of the ilioinguinal and iliohypogastric nerves with observations of their spinal nerve contributions. Clin Anat 24(4):454–461. https://doi.org/10.1002/ca.21098 PubMed DOI
Lanz T, Wachsmuth W (1972) Praktische Anatomie, vol 1, part 4. Springer-Verlag, Berlin, Heidelberg, New York, p 199
Le Double AF (1897) Traité des variations du système musculaire de L’homme. Schleicher, Paris
Macalister A (1871) Additional observations on muscular anomalies in human anatomy (3rd series), with a catalogue of the principal muscular variations hitherto published. Trans R Ir Acad 25:1–134
Ray B, D’Souza AS, Kumar B, Marx C, Ghosh B, Gupta NK, Marx A (2010) Variations in the course and microanatomical study of the lateral femoral cutaneous nerve and its clinical importance. Clin Anat 23(8):978–984. https://doi.org/10.1002/ca.21043 PubMed DOI
Saniotis A, Henneberg M (2021) Anatomical variations and evolution: re-evaluating their importance for surgeons. ANZ J Surg 91(5):837–840. https://doi.org/10.1111/ans.16429 PubMed DOI
Standring S (ed) (2020) Gray’s anatomy: the anatomical basis of clinical practice, 42nd edn. Elsevier, London
Testut L (1884) Les anomalies musculaires Chez L’homme. Masson, Paris
Thompson N (1971) Autogenous free grafts of skeletal muscle: A preliminary experimental and clinical study. Plast Reconstr Surg 48(1):11–27. https://doi.org/10.1097/00006534-197107000-00004 PubMed DOI
Tomaszewski KA, Popieluszko P, Henry BM, Roy J, Sanna B, Kijek MR, Walocha JA (2016) The surgical anatomy of the lateral femoral cutaneous nerve in the inguinal region: a meta-analysis. Hernia 20:649–657. https://doi.org/10.1007/s10029-016-1493-7 PubMed DOI PMC
Tubbs RS, Shoja MM, Loukas M (eds) (2016) Bergman’s comprehensive encyclopedia of human anatomic variation. Wiley
Włudyka K, Zielinska N, Tubbs RS, Maślanka K, Borowski A, Drobniewski M, Olewnik Ł (2024) Morphological variability of lateral femoral cutaneous nerve and its potential clinical significance. Folia Morphol. https://doi.org/10.5603/fm.98624 DOI
Yang D, Morris SF, Sigurdson L (1999) The sartorius muscle: anatomic considerations for reconstructive surgeons. Surg Radiol Anat 20:307–310. https://doi.org/10.1007/bf01630610 DOI