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Procedures such as saphenous vein cutdown or orthopedic surgery that includes incisions or dissection over the distal tibia or medial malleolus can result in damage to the saphenous nerve, resulting in loss of cutaneous sensation in the medial leg. This is due to the intimate path that the saphenous nerve and the great saphenous vein travel.
When this is so, it emerges from beneath the lower border of the adductor longus muscle, descends along the posterior margin of the sartorius muscle to the medial side of the knee, where it pierces the deep fascia, communicates with the saphenous nerve, and is distributed to the skin of the tibial side of the leg as low down as its middle.
The medial cutaneous nerve, before dividing, gives off a few filaments, which pierce the fascia lata, to supply the integument of the medial side of the thigh, accompanying the long saphenous vein. One of these filaments passes through the saphenous opening; a second becomes subcutaneous about the middle of the thigh; a third pierces the fascia ...
It is a fine network of communicating nerve fibres. [2] It is formed by the anterior division of lateral femoral cutaneous nerve, terminal branches of the intermediate femoral cutaneous nerve, terminal branches of the medial femoral cutaneous nerve, and the infrapatellar branch of saphenous nerve. [1] [2]
Common fibular nerve (blue) - labeled as "peroneal nerve". Also Lateral sural cutaneous nerve. Saphenous nerve (pink), a branch of the femoral nerve. Superficial fibular nerve (yellow) - labeled as "superficial peroneal nerve". Also Medial dorsal cutaneous nerve. Sural nerve (brown). Also Medial sural cutaneous nerve.
The infrapatellar branch of saphenous nerve is a nerve of the lower limb. [1] The saphenous nerve, located about the middle of the thigh, gives off a branch which joins the subsartorial plexus. It pierces the sartorius and fascia lata, and is distributed to the skin in front of the patella.
Then, the saphenous nerve and artery and vein of genus descendens exit through the anterior foramen, piercing the vastoadductor intermuscular septum. Finally, the femoral artery and vein exit via the inferior foramen (usually called the hiatus ) through the inferior space between the oblique and medial heads of adductor magnus.
The saphenous nerve block is often done in combination with the popliteal block for surgeries below the knee. [53] The saphenous nerve is numbed at the medial part of the lower thigh under the sartorius muscle. [53] The lumbar plexus block is an advanced technique indicated for hip, anterior thigh, and knee surgery. [54]