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ANATOMICAL VARIABILITY OF CUTANEOUS NERVES OF ANTERIOR FEMORAL REGION IN HUMAN FETUSES
Abstract
Objective:
The aim: Is to find out the features of innervation of the skin of the anterior femoral region and the fascia lata during the fetal period of human development.
Patients and methods:
Materials and methods: The study was carried out on 64 preparations of the lower extremities of human fetuses of 4-10 months using macromicroscopic preparation and morphometry. Macropreparations of the skin nerves of the lower extremities of different age fetuses with anatomical variants were subject to photo documentation.
Results:
Results: The features of cutaneous nerve fetal topography of the anterior femoral region and the broad fascia of the femur were revealed, their connections were established, and their layering was determined. It was found that in human fetuses, not only the lateral cutaneous femoral nerve but in most cases the branches of other nerves of the lumbar plexus, except for the obturator nerve, are directed to the skin of the anterior-lateral femur surface. The innervation of the medial femur surface is provided by the following nerve complex: obturator, femoral, saphenous and genitofemoral nerves.
Conclusion:
Conclusions: Taking into account the fact that the terminal branches of adjacent cutaneous nerves of the femoral region intersect and overlap, innervation bypasses are formed, due to which, in case of possible damage to one of the nerves, its insufficiency is compensated to a certain extent. Anastomoses were found between the cutaneous nerves, in the form of loops of various shapes and sizes, namely: between the cutaneous-fascia branches of the femoral and ilioinguinal nerves and the femoral and obturator nerves.
... These include differences associated with crossing the anterior superior iliac crest, distances from the ASIS at the level of the IL, the distance to crossing the sartorius muscle, and the angle it creates with the IL. Morphological variability has been observed among both adult cadavers and fetuses [16]. ...
... Hryhorieva et al. [16] investigated the characteristics of sensory innervation of the anterior femoral region and the fascia lata in fetuses. Sixty-four preparations of lower extremities of fetuses were examined. ...
... In order to prevent mutilation of the nerves, they were prepared following the sequence in which they arise from the lumbar plexus: iliohypogastric, ilio-inguinal, branches of either ilio-inguinal or genitofemoral, and finally the lateral femoral cutaneous, femoral and obturator nerves. This particular sequence allowed the variability in innervation, overlapping zones and anastomoses between nerves to be demonstrated [16]. ...
Background: The lateral femoral cutaneous nerve is derived from the dorsal branches of the
L2 and L3 spinal nerves. It travels across the pelvis and heads towards the anterior superior
iliac spine. It passes under the lateral part of the inguinal ligament and then divides into two
branches, which are responsible for sensory innervation of the anterolateral and lateral skin of
the thigh. However, the course of this nerve can vary morphologically. Numerous differences
1
have been observed in its exit from the pelvis and in the number of its main trunks and
branches. Additionally, its angle with the inguinal ligament and its placement in relation to
other structures (such as the femoral artery, femoral nerve, and the sartorius and iliacus
muscles) also vary. All of these variants have potential clinical implications. Therefore, the
aim of this review is to present the morphological variability of the lateral cutaneous nerve
and to explore how these anatomical differences can introduce clinical concerns.
Materials and methods: Presented review of the literature was written based on over 30
studies. Comprehensive literature search was done using PubMed in order to study the
morphological variability of lateral femoral cutaneous nerve (LFCN). To be included in this
review studies needed to be meet certain criteria: been published before December 2023,
present information valuable to this paper (variability of lateral femoral cutaneous
nerve/clinical significance). The search included how LFCN vary either among fetuses and
adults in the aim of providing more complex information about the variability of this nerve.
During the search key words as following were used. No particular references were excluded
from the analysis. All relevant studies were included, and citation tracking was used to
identify publications.
Results: This review presents the description of variability of LFCN and its potential clinical
impact. In the review differences in adult and fetuses were considered, morphological
variability were divided into 4 groups: the origin of the nerve, the way it leaves the pelvis, the
branching pattern, the angle between LFCN and surrounding structures and then, clinical
significance were considered basing on available literature.
... We performed a meta-regression for the presence of lower limb nerve compressions associated with anatomical variants, which shows whether the data present a low bias and whether they can be included in a meta-analysis based on the dependent and independent variables ( Figure 6). The thigh region prevalence forest plot was based on five studies [52,55,59,60,63], which presented a prevalence of 0.10 (0.03-0.17) and a heterogeneity of 91.18% (Figure 7). For this comparison, the funnel plot graph showed asymmetry, indicating the presence of publication bias or factors influencing the results (Figure 8). ...
... A forest plot for the prevalence of nerve compressions of the thigh region associated with anatomical variants of surrounding structures[53,55,59,60]. ...
... A funnel plot of nerve compressions of the thigh region associated with anatomical variants of surrounding structures[53,55,59,60]. ...
Objective: The aim of this study was to describe the main anatomical variants and mor-phofunctional alterations in the lower limb that compress surrounding nervous structures in the gluteal region, thigh region, and leg and foot region. Methods: We searched the Medline, Scopus, Web of Science, Google Scholar, CINAHL, and LILACS databases from their inception up to Octo-ber 2023. An assurance tool for anatomical studies (AQUA) was used to evaluate methodological quality, and the Joanna Briggs Institute assessment tool for case reports was also used. Forest plots were generated to assess the prevalence of variants of the gluteal region, thigh, and leg. Results: According to the forest plot of the gluteal region, the prevalence was 0.18 (0.14-0.23), with a heter-ogeneity of 93.52%. For the thigh region, the forest plot presented a prevalence of 0.10 (0.03-0.17) and a heterogeneity of 91.18%. The forest plot of the leg region was based on seven studies, which presented a prevalence of 0.01 (0.01-0.01) and a heterogeneity of 96.18%. Conclusions: This review and meta-analysis showed that, in studies that analyzed nerve compressions, the prevalence was low in the thigh and leg regions, while in the gluteal region, it was slightly higher. This is mainly due to the PM region and its different variants. We believe that it is important to analyze all the variant regions defined in this study and that surgeons treating the lower limb should be a entive to these possible scenarios so that they can anticipate possible surgical situations and thus avoid surgical complications. Citation: Valenzuela-Fuenzalida, J.J.; Inostroza-Wegner, A.; Osorio-Muñoz, F.; Milos-Brandenberg, D.; Machuca, A.S.; Nova Baeza, P.; Donoso, M.O.; Mejias, A.B.; Iwanaga, J.; Gimeno, J.S.; et al. The Association between Anatomical
... mm of parietal-coccygeal length (PCL) to find out the features of innervation of the calf muscles using the specimens of their lower extremities by means of fine dissection methods, vascular injection, and morphometry. Specimens of fetuses from the Museum of the Department of Human Anatomy named after M.H. Turkevych and the Department of Histology, Cytology and Embryology of Bukovinian State Medical University were involved in the study 19,20 ...
Cutaneous nerve entrapment plays an important role in neuropathic pain syndrome. Due to the advancement of ultrasound technology, the cutaneous nerves can be visualized by high-resolution ultrasound. As the cutaneous nerves course superficially in the subcutaneous layer,
they are vulnerable to entrapment or collateral damage in traumatic insults. Scanning of the cutaneous nerves is challenging due to fewer anatomic landmarks for referencing. Therefore, the aim of the
present article is to summarize the anatomy of the limb cutaneous nerves, to elaborate the scanning techniques, and also to discuss the clinical implications of pertinent entrapment syndromes of the
medial brachial cutaneous nerve, intercostobrachial cutaneous nerve, medial antebrachial cutaneous nerve, lateral antebrachial cutaneous nerve, posterior antebrachial cutaneous nerve, superficial branch
of the radial nerve, dorsal cutaneous branch of the ulnar nerve, palmar cutaneous branch of the median nerve, anterior femoral cutaneous nerve, posterior femoral cutaneous nerve, lateral femoral
cutaneous nerve, sural nerve, and saphenous nerve.
Background:
In neonatal and early childhood surgeries such as meningomyelocele repairs, closing deep wounds and oncological treatment, tensor fasciae lata (TFL) flaps are used. However, there are not enough data about structural properties of TFL in foetuses, which can be considered as the closest to neonates in terms of sampling. This study's main objective is to gather data about morphological structures of TFL in human foetuses to be used in newborn surgery.
Materials and methods:
Fifty formalin-fixed foetuses (24 male, 26 female) with gestational age ranging from 18 to 30 weeks (mean 22.94 ± 3.23 weeks) were included in the study. TFL samples were obtained by bilateral dissection and then surface area, width and length parameters were recorded. Digital callipers were used for length and width measurements whereas surface area was calculated using digital image analysis software.
Results:
No statistically significant differences were found in terms of numerical value of parameters between sides and sexes (p > 0.05). Linear functions for TFL surface area, width, anterior and posterior margin lengths were calculated as y = -225.652 + 14.417 × age (weeks), y = -5.571 + 0.595 × age (weeks), y = -4.276 + 0.909 × age (weeks), and y = -4.468 + 0.779 × age (weeks), respectively.
Conclusions:
Linear functions for TFL surface area, width and lengths can be used in designing TFL flap dimensions in newborn surgery. In addition, using those described linear functions can also be beneficial in prediction of TFL flap dimensions in autopsy studies.
Introduction:
Compression of the lateral femoral cutaneous nerve (LFCN), known as meralgia paresthetica (MP), is common. We investigated the topographic anatomy of the LFCN focusing on the inguinal ligament and adjacent structures.
Methods:
Distances from various bony and soft-tissue landmarks to the LFCN were investigated in 33 formalin-embalmed cadavers.
Results:
The mean distance from the anterior superior iliac spine (ASIS) to the LFCN was 8.8 mm. In approximately 90% of cases, the LFCN lay <2 cm from the medial tip of the ASIS, while in 76% of cases it was <1 cm away. The mean angle between the inguinal ligament and LFCN was 83.3°.
Conclusions:
We determined the variability of the location of the LFCN at the boundary between the pelvic and femoral portions. The reported results will be helpful for diagnosis and treatment of MP. This article is protected by copyright. All rights reserved.
Purpose: Several variations in the anatomy and injury of the lateral femoral cutaneous nerve (LFCN) have been studied since 1885. The aim of our study was to analyze the available data on the LFCN and find a true prevalence to help in the planning and execution of surgical procedures in the area of the pelvis, namely inguinal hernia repair.
Methods: A search of the major medical databases was performed for LFCN anatomy. The anatomical data were collected and analyzed.
Results: Twenty-four studies (n = 1,720) were included. The most common pattern of the LFCN exiting the pelvis was medial to the Sartorius as a single branch. When it exited in this pattern, it did so on average 1.90 cm medial to the anterior superior iliac spine (ASIS).
Conclusions: The LFCN and its variations are important to consider especially during inguinal hernia repair, abdominoplasty, and iliac bone grafting. We suggest maintaining a distance of 3 cm or more from the ASIS when operating to prevent injury to the LFCN.
Similarly to entrapment neuropathies of upper extremities, the ultrasound constitutes
a valuable supplementation of diagnostic examinations performed in patients with suspicions
of nerve entrapment syndromes of the lower limb. For many years, it was claimed
that such pathologies were rare. This probably resulted from the lack of proper diagnostic
tools (including high frequency ultrasound transducers) as well as the lack of sufficient
knowledge in this area. In relation to the above, the symptoms of compression neuropathies
were frequently interpreted as a manifestation of pathologies of the lumbar part
of the spine or a other orthopedic disease (degenerative or overuse one). Consequently,
many patients were treated ineffectively for many months and even, years which led to
irreparable neurological changes and changes in the motor organ. Apart from a clinical
examination, the diagnostics of entrapment neuropathies of lower limb is currently based
on imaging tests (ultrasound, magnetic resonance) as well as functional assessments
(electromyography). Magnetic resonance imaging is characterized by a relatively low
resolution (as compared to ultrasound) which results in limited possibilities of morphological
evaluation of the visualized pathology. Electromyography allows for the assessment
of nerve function, but does not precisely determine the type and degree of change.
This article presents examples of the most common entrapment neuropathies of the lower
limb concerning the following nerves: sciatic, femoral, lateral femoral cutaneous, obturator,
fibular and its branches, tibial and its branches as well as sural. The pathomorphological
basis of the neuropathies as well as corresponding ultrasound images are presented
in this paper. Attention has been drawn to echogenicity, degree of vascularization and
bundle presentation of the trunk of a pathological peripheral nerve.
Entrapment neuropathies can manifest with confusing clinical features and therefore are often underrecognized and underdiagnosed at clinical examination. Historically, electrophysiologic evaluation has been considered the mainstay of diagnosis. Today, cross-sectional imaging, particularly magnetic resonance (MR) imaging and specifically MR neurography, plays an increasingly important role in the work-up of entrapment neuropathies. MR imaging is a noninvasive operator-independent technique that allows identification of the underlying cause of injury, differentiation between surgically treatable and untreatable causes, and guidance of selective diagnostic anesthetic nerve blocks. Pathologic conditions affecting the lumbosacral plexus and major motor and mixed nerves of the pelvis and hip include neuropathies of the lumbosacral plexus, femoral nerve, lateral femoral cutaneous nerve, obturator nerve, and sciatic nerve; piriformis muscle syndrome; and injury of the gluteal nerves. Diagnosis of entrapment neuropathies of the pelvis and hip with MR imaging requires familiarity with the normal MR imaging anatomy and awareness of the anatomic and pathologic factors that put peripheral nerves at risk for injury.
This study used dissection of 34 lumbar plexes to look at the prevalence of anatomical variations in the lumbar plexus and the six peripheral branches from the origin at the ventral roots of (T12) L1-L4 to the exit from the pelvic cavity. Prevalence of anatomical variation in the individual nerves ranged from 8.8-47.1% with a mean prevalence of 20.1%. Anatomical variations included absence of the iliohypogastric nerve, an early split of the genitofemoral nerve into genital and femoral branches, an aberrant segmental origin for the lateral femoral cutaneous nerve, bifurcation of the lateral femoral nerve prior to exiting the pelvic cavity, bifurcation of the femoral nerve into two to three slips separated by psoas major muscle fibers, the presence of a single anterior femoral cutaneous nerve rather than the normal presentation of two separate anterior femoral cutaneous branches, and the presence of an accessory obturator nerve. Comparison with relevant research literature showed a wide variation in reported prevalence of the anatomical variations noted in this study. Clinical implications and directions for future research are proposed.
Abdominal wall closure is not possible in large congenital defects, even after extensively stretching in to enlarge its capacity. The skin coverage is usually adequate but the aponeurotic defect has to be closed temporally using synthetic patches. The use of these materials leads to increase complication such as infection, fistula formation and extrusion. In addition a second operation is required to remove the material and to perform a definitive closure. The role of fascia lata in reconstruction of abdominal wall is well established as free grafts, pedicled flaps or free flaps. Bank cadaveric fascia lata is used extensively in neurosurgical, ophtalmological, orthopaedic and urogynecological procedures. This is the first description of the use of cadaveric fascia lata for the closure of large abdominal wall defects.
We present two cases of congenital diaphragmatic hernia. The first patient was a newborn who presented the impossibility to close the fascia, that was salvaged by a teflón patch. Five months later the wound opened, leaving the mesh exposed that had to be removed. A cadaveric fascia lata patch was used to cover the defect, closing the skin satisfactorily. The second case was a two days newborn. We performed the diaphragmatic closure, and the aponeurotic defect was closed using cadaveric fascia lata.
Cosmetic and functional appearance are satisfactory in both cases and no complications have been seen.
Fascia lata patches are revascularized in the abdominal wall and incorporates into receptor tissue. They have the following advantages with respect to synthetic materials: First, the risk of complications is lower. Second, their removal is not necessary. Finally, no intraperitoneal adhesions occur. The risks of disease transmission and rejection are minimized by the Centro Comunitario de Transfusiones donor selection and processing of the cadaveric fascia lata.
Purpose Neuropathy of the intermediate (IFCN) and medial femoral cutaneous nerve (MFCN) is a potential iatrogenic complication of thigh surgery and its diagnosis is limited. This study aimed to evaluate the possibility of the visualization and diagnostic assessment of the IFCN and MFCN with high-resolution ultrasound (HRUS).
Materials and Methods In this study, HRUS with high-frequency probes (15 – 22MHz) was used to locate the IFCN and the MFCN in 16 fresh cadaveric lower limbs. The correct identification of the nerves was verified by ink-marking and consecutive dissections at sites correlating to nerve positions (R1 – 3), namely, the origin, the mid portion, and the distal portion, respectively. 12 cases with suspected IFCN and MFCN lesions referred to our clinic for HRUS examinations were also assessed.
Results Anatomical dissection confirmed the correct identification of the IFCN in 16/16 branches at all of the different locations (100 %). MFCN was correctly identified at R1 + 3, in all cases (16/16; 100 %), and in 14/16 cases (88 %) at (R2). 12 cases of patients with IFCN and MFCN pathologies (all of iatrogenic origin) were identified. 9 instances of structural damage were visible on HRUS, and all pathologies were confirmed by almost complete resolution of symptoms after selective HRUS-guided blocks with 0.5 – 1 ml lidocaine 2 %.
Conclusion This study confirms that the IFCN and the MFCN can be reliably visualized with HRUS throughout the course of these nerves, both in anatomical specimens and in patients.
Wide bilateral cleft lip deformity reconstruction represents a special difficulty as it affects the lip, nose, and maxillary segments making single-stage reconstruction sometimes unobtainable. Many surgical and nonsurgical techniques have been prescribed to facilitate the definitive repair. Although some of these techniques proved to be useful, they have their inherent limitations and add another treatment step with all its possible complications and costs. The authors present a new method to address muscle layer repair in 1-stage procedure. It entails using fascial graft obtained from the temporalis muscle fascia or fascia lata, to reconstruct orbicularis oris lip muscle. Seven patients of wide bilateral cleft lip deformity (mean 17 mm) with a mean age of 4.4 months were subjected to single-stage lip reconstruction. After measuring the defect between both lateral muscle segments in front of the premaxilla intraoperatively ensuring that direct muscle repair could not be obtained, a fascial graft was harvested and sutured to both muscle edges. The authors found that, regardless the defect size or premaxilla protrusion, all wide clefts could be reconstructed satisfactorily in 1 stage procedure. No serious postoperative complications have been encountered in the lip or donor areas. Early follow-up reporting of the patients revealed stable repair. However more follow-up is still needed to assess late sequelae. In conclusion, fascial graft muscle repair of wide bilateral cleft lip deformity enables early 1-stage lip reconstruction without tension. The added donor morbidity is minimal and well tolerated.
OBJECTIVE: Meralgia paresthetica causes dysesthesias and burning in the anterolateral thigh. Surgical treatment includes nerve transection or decompression. Finding the nerve in surgery is very challenging. The author conducted a cadaveric study to better understand the variations in the anatomy of the lateral femoral cutaneous nerve (LFCN). METHODS: Twenty embalmed cadavers were used for this study. The author studied the LFCN's relationship to different fascial planes, and the distance from the anterior superior iliac spine (ASIS). RESULTS: A complete fascial canal was found to surround the nerve completely in all specimens. The canal starts at the inguinal ligament proximally and follows the nerve beyond its terminal branches. The nerve could be anywhere from 6.5 cm medial to the ASIS to 6 cm lateral to the ASIS. In the latter case, the nerve may lodge in a groove in the iliac crest. Other anatomical variations found were the LFCN arising from the femoral nerve, and a duplicated nerve. A thick nerve was found in 1 case in which it was riding over the ASIS. CONCLUSIONS: The variability in the course of the LFCN can create difficulty in surgical exposure. The newly defined LFCN canal renders exposure even more challenging. This calls for high-resolution pre- or intraoperative imaging for better localization of the nerve.
Fascia lata is an important element of the fascial system, which forms the continuum of connective tissue throughout the body. This deep fascia envelops the entire thigh and hip area and its main function is to transmit mechanical forces generated by the musculoskeletal system of the lower extremities. Fascia lata is also known as a useful and easily harvested graft material. Despite its crucial role in lower extremity biomechanics and wide-ranging applications in plastic and reconstructive surgery, both the structure of fascia lata and particularly the cells populating this tissue are relatively unexplored and therefore poorly understood. The aim of this study was to characterize the main cell populations encountered within human fascia lata and to try to understand their role in health and diseases. Pathologically unchanged human fascia lata was obtained post mortem from adult males. The specimens were analyzed under light, electron, and confocal microscopy. On the basis of different visualization techniques, we were able to characterize in detail the cells populating human fascia lata. The main cells found were fibroblasts, fibrocytes, mast cells, cells showing myoid differentiation, nerve cells, and most interestingly, telocytes. Our results supplement the formerly inadequate information in the literature regarding the cellular components of deep fascial structure, may contribute to a better understanding of the pathogenesis of fascial disorders and improve fascia lata application as a graft material.
Compared with the upper limbs, sonographic tracking of peripheral nerves in the lower limbs is more challenging. The overlying muscles are larger, hindering visualization of the deeply embedded nerves by using a linear transducer. The use of a curvilinear transducer-providing an extended view with better penetration for the field of interest-may be useful for scanning the nerves in the hip and thigh. Application of the Doppler mode helps localization of the target nerve by identifying the accompanying vessels. Aiming to demonstrate the relevant tracking techniques, the present article comprises a series of ultrasound images and videos showing how to scan the nerves in the lower limb, that is, femoral, obturator, pudendal, lateral femoral cutaneous, sciatic, saphenous, sural, tibial, and peroneal nerves. Copyright
Ultrasound has been the most useful imaging tool for musculoskeletal disorders whereby peripheral nerve lesions constitute a substantial portion. High-resolution ultrasound enables elaboration of peripheral nerve morphology and reciprocal anatomy. However, limited literature is available for delineating standard positions and tracking skills. The present article incorporates a series of ultrasound images and videos to demonstrate how to scan the suprascapular, axillary, musculocutaneous, median, ulnar, and radial nerves. Overall, the authors aim to demonstrate the relevant nerve tracking techniques as regards the upper extremity.
Chronic inguinodynia is one of the most frequent complications after groin herniorrhaphy. We investigated the retroperitoneal anatomy of the iliohypogastric, ilioinguinal, genitofemoral, and lateral femoral cutaneous nerve to prevent direct nerve injury during hernia repairs and to find the most advantageous approach for posterior triple neurectomy.
We dissected the inguinal nerves in 30 human anatomic specimens bilaterally. The distances from each nerve and their entry points in the abdominal wall were measured in relation to the posterior superior iliac spine, anterior superior iliac spine, and the midpoint between the two iliac spines on the iliac crest. We evaluated our findings by creating high-resolution summation images.
The courses of the iliohypogastric and ilioinguinal nerve are most consistent on the anterior surface of the quadratus lumborum muscle. The genitofemoral nerve always runs on the psoas muscle. The entry points of the nerves in the abdominal wall are located as follows: the iliohypogastric nerve is above the iliac crest and lateral from the anterior superior iliac spine, the ilioinguinal nerve is with great variability, either above or below the iliac crest and lateral from the anterior superior iliac spine, the genital branch is around the internal inguinal ring, the femoral branch is either cranial or caudal to the iliopubic tract, and the lateral femoral cutaneous nerve is either medial or lateral to the anterior superior iliac spine.
Nerve injury during inguinal hernia repairs can be avoided by taking the topographic anatomy of the inguinal nerves into consideration. The most advantageous plane to look for the iliohypogastric and ilioinguinal nerve during posterior neurectomy is on the anterior surface of the quadratus lumborum muscle. For the surgical treatment of severe chronic inguinodynia, especially after posterior open or endoscopic mesh repair (TAPP/TEP), the retroperitoneoscopic or open retroperitoneal approach for posterior triple neurectomy can be considered.
The purpose of our study was to determine the location of the lateral femoral cutaneous nerve and its branches at the inguinal ligament and proximal thigh. We think that further defining the location of the nerve and its branches based on certain measurements from known anatomic landmarks would enable us to determine a danger zone that could aid in preventing iatrogenic injury to the lateral femoral cutaneous nerve. The anatomic course of the lateral femoral cutaneous nerve was studied in 29 cadaver specimens and distances from various landmarks were recorded. In addition, the branching pattern of the nerves was recorded. We observed variability in the course and branching patterns of the lateral femoral cutaneous nerve. The lateral femoral cutaneous nerve was found to potentially be at risk as far as 7.3 cm medial to the anterior superior iliac spine along the inguinal ligament and as much as 11.3 cm distal on the sartorius muscle from the anterior superior iliac spine. As many as five branches of the lateral femoral cutaneous nerve were found and in 27.6% of cases the lateral femoral cutaneous nerve branched before traversing the inguinal ligament. We used this information to describe a danger zone, which could be used as a guide to help prevent unnecessary injury during certain procedures.
This study investigates the topographical relationship of the lateral femoral cutaneous nerve (LFCN) to the anterior iliac crest and its clinical relevance in the context of bone graft harvesting. In the anatomical part of the study, LFCN was dissected and its course investigated in 34 human formalin-embalmed cadavers. In the clinical part, data of patients who underwent an iliac crest bone grafting procedure were collected and analysed. The obtained results were then compared with the results of other investigators published in the medical literature. From 34 nerves, the lateral branch of 1 LFCN (2.9%) crossed the anterosuperior iliac spine (ASIS) prominence at a distance less than 5mm superolaterally from the most anterior point of the spine. All other nerves ran below the inguinal ligament with an average distance of 14.6mm in the inferomedial direction from the spine. In 4 out of 298 patients (1.3%) who underwent harvesting of monocortical bone grafts from the inner table of the ilium, sensory disturbances in the dermatome of LFCN were observed. After a maximum period of 12 months all sensory disturbances resolved so that no case of permanent sensory impairment was recorded. The relatively low incidences of iatrogenic LFCN damage can be attributed to a standardized surgical concept which employs a lateral incision and layer by layer dissection to the periosteum/iliacal fascia level in order to identify the nerves potentially crossing the iliac crest above the ASIS.