Background

Incomplete peripheral nerve blocks distal to the popliteal region are commonly considered a sciatic and femoral/saphenous nerve block failure. The existence of a much more distal innervation area of the posterior femoral cutaneous nerve (PFCN) as described has not been assumed yet. We therefore investigated the distal termination of the PFCN in the lower leg.

Methods

In 83 human lower extremities embalmed with Theil's method, the course of the PFCN was investigated from the sub-gluteal fold to the most distal macroscopically dissectible branch. The topographic connection to other landmarks, such as the small saphenous vein or small arteries, was investigated.

Results

Popliteal ending of the PFCN was found in 9.7% of cases. The PFCN terminated at the proximal or distal lower leg in 45.7% and 44.6% of cases, respectively. The PFCN had a close connection to the Achilles tendon in 13.2% of cases and was found distally to the medial malleolus in one case. The small saphenous vein was close to the PFCN in 90.3% of cases and can therefore be used as a landmark to identify the nerve. In 40.9% of cases, the PFCN was accompanied by a small descending branch of the inferior gluteal artery. In two cases, an innervation of the fibula or calcaneus periosteum was found.

Conclusions

The PFCN has a much more distal termination in the lower leg than previously demonstrated. To ensure complete anaesthesia of the lower leg and foot, the PFCN must be included in combined peripheral nerve block procedures.

中文翻译：

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股后皮神经对小腿的感觉神经有重要贡献：解剖学研究

背景

the神经远端远端的不完全周围神经阻滞通常被认为是坐骨神经和股神经/大隐神经阻滞。如前所述，股骨后皮神经（PFCN）远侧神经支配区域的存在尚未被假定。因此，我们研究了PFCN在小腿中的远端端接。

方法

在83例用Theil法防腐的人类下肢中，研究了PFCN的过程，从臀下褶皱到最远端的宏观可解剖分支。研究了与其他地标（如小隐静脉或小动脉）的地形连接。

结果

在9.7％的病例中发现了PFCN的末。PFCN分别在45.7％和44.6％的病例终止于近端或远端小腿。PFCN在13.2％的病例中与跟腱紧密相连，其中1例被发现在踝部远端。在90.3％的病例中，小隐静脉靠近PFCN，因此可以用作识别神经的标志。在40.9％的病例中，PFCN伴有臀下动脉的小降支。在两种情况下，发现腓骨或跟骨骨膜的神经支配。

结论

PFCN在小腿中的远端末端比以前显示的要多得多。为了确保小腿和足部完全麻醉，在合并的周围神经阻滞手术中必须包括PFCN。