Re-defining the anatomical structures for blocking the nerves in adductor canal and sciatic nerve through the same injection site: an anatomical study
Purpose The aim of this study is to re-define the anatomical structures which are important for blocking the sciatic nerve and the nerves within the adductor canal which innervate the knee joint through the same injection site. We also aimed to investigate the spread of the anesthetic toward the are...
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| Veröffentlicht in: | Surgical and radiologic anatomy (English ed.) 2018-11, Vol.40 (11), p.1267-1274 |
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| container_title | Surgical and radiologic anatomy (English ed.) |
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| creator | Kendir, S. Torun, Bilge İpek Akkaya, T. Comert, A. Tuccar, E. Tekdemir, I. |
| description | Purpose
The aim of this study is to re-define the anatomical structures which are important for blocking the sciatic nerve and the nerves within the adductor canal which innervate the knee joint through the same injection site. We also aimed to investigate the spread of the anesthetic toward the areas in which the mentioned nerves lie on cadavers.
Methods
This study was performed on 16 lower extremities of formaldehyde-embalmed eight adult cadavers. The anatomy of adductor canal, courses of the nerves within the canal and the relationships of the saphenous, medial femoral cutaneous, medial retinacular, posterior branch of the obturator and sciatic nerves with each other and with the fascial compartments were investigated. Transverse sections that crossed the superior border of vastoadductor membrane were taken to reach the sciatic nerve in the shortest way. Colored latex was injected to demonstrate the anesthetic blockage of the targeted nerves. The structures along the needle’s way were investigated.
Results
The saphenous, medial femoral cutaneous and at its distal part posterior branch of the obturator nerve were colored with latex within the adductor canal. The nerve to vastus medialis (in other words, the medial retinacular nerve) lay beneath the fascia of vastus medialis and did not enter the adductor canal. There was a fascial plane which did not allow the passage of colored latex toward the sciatic nerve. To traverse this fascial structure, it was found out to be necessary to insert the needle perpendicular to both the vertical and transverse axes of the thigh and then advance it along 2/3 of diameter of the thigh. Thus, the colored latex was observed to fill the compartment where the sciatic nerve lay within.
Conclusions
Blocking the sciatic nerve and the nerves within the adductor canal which innervate the knee joint through the same injection site seems anatomically possible without injuring any neurovascular structures. |
| doi_str_mv | 10.1007/s00276-018-2094-1 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2098762525</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2098762525</sourcerecordid><originalsourceid>FETCH-LOGICAL-c372t-fda773d96e5285c1f7ef7dfcebeae4bfd8012eccb76b2746928f751eadec61d53</originalsourceid><addsrcrecordid>eNp1kd9qFTEQh4Mo9rT6AN7IgjfeRGeyf5L1TopWoSCIXi_ZZHKa4-6mJlmhL-LzmtNtFQWvApnvm2Hmx9gzhFcIIF8nACE7Dqi4gL7h-IDtUMieqxblQ7aDvgaOUKsTdprSAQBaRPWYndSAnVSi2bGfn4lbcn7xy77KV1TpRecwe6OnKuW4mrxGSpULsRqnYL7dYwvFH-XfL5W2tlClboo6Fd9WyXidvdmggsew7q9utaRnKtKBTPZhqZLP9KYof09d7c0T9sjpKdHTu_eMfX3_7sv5B3756eLj-dtLbmopMndWS1nbvqNWqNagk-SkdYZG0tSMzipAQcaMshuFbLpeKCdbJG3JdGjb-oy93Ppex_B9pZSH2SdD06QXCmsaylmV7EQrjuiLf9BDWGNZ-ZaS5ezQ94XCjTIxpBTJDdfRzzreDAjDMbRhC20ooR29ZsDiPL_rvI4z2d_GfUoFEBuQSmnZU_wz-v9dfwELv6V1</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2097279099</pqid></control><display><type>article</type><title>Re-defining the anatomical structures for blocking the nerves in adductor canal and sciatic nerve through the same injection site: an anatomical study</title><source>MEDLINE</source><source>SpringerLink Journals - AutoHoldings</source><creator>Kendir, S. ; Torun, Bilge İpek ; Akkaya, T. ; Comert, A. ; Tuccar, E. ; Tekdemir, I.</creator><creatorcontrib>Kendir, S. ; Torun, Bilge İpek ; Akkaya, T. ; Comert, A. ; Tuccar, E. ; Tekdemir, I.</creatorcontrib><description>Purpose
The aim of this study is to re-define the anatomical structures which are important for blocking the sciatic nerve and the nerves within the adductor canal which innervate the knee joint through the same injection site. We also aimed to investigate the spread of the anesthetic toward the areas in which the mentioned nerves lie on cadavers.
Methods
This study was performed on 16 lower extremities of formaldehyde-embalmed eight adult cadavers. The anatomy of adductor canal, courses of the nerves within the canal and the relationships of the saphenous, medial femoral cutaneous, medial retinacular, posterior branch of the obturator and sciatic nerves with each other and with the fascial compartments were investigated. Transverse sections that crossed the superior border of vastoadductor membrane were taken to reach the sciatic nerve in the shortest way. Colored latex was injected to demonstrate the anesthetic blockage of the targeted nerves. The structures along the needle’s way were investigated.
Results
The saphenous, medial femoral cutaneous and at its distal part posterior branch of the obturator nerve were colored with latex within the adductor canal. The nerve to vastus medialis (in other words, the medial retinacular nerve) lay beneath the fascia of vastus medialis and did not enter the adductor canal. There was a fascial plane which did not allow the passage of colored latex toward the sciatic nerve. To traverse this fascial structure, it was found out to be necessary to insert the needle perpendicular to both the vertical and transverse axes of the thigh and then advance it along 2/3 of diameter of the thigh. Thus, the colored latex was observed to fill the compartment where the sciatic nerve lay within.
Conclusions
Blocking the sciatic nerve and the nerves within the adductor canal which innervate the knee joint through the same injection site seems anatomically possible without injuring any neurovascular structures.</description><identifier>ISSN: 0930-1038</identifier><identifier>EISSN: 1279-8517</identifier><identifier>DOI: 10.1007/s00276-018-2094-1</identifier><identifier>PMID: 30167824</identifier><language>eng</language><publisher>Paris: Springer Paris</publisher><subject>Aged ; Aged, 80 and over ; Anatomic Landmarks ; Anatomy ; Cadaver ; Cadavers ; Dissection ; Fascia ; Female ; Femoral Nerve - anatomy & histology ; Femur ; Humans ; Imaging ; Injection ; Knee ; Knee Joint - innervation ; Latex ; Male ; Medicine ; Medicine & Public Health ; Middle Aged ; Nerve Block ; Nerves ; Obturator Nerve - anatomy & histology ; Original Article ; Orthopedics ; Pilot Projects ; Radiology ; Sciatic nerve ; Sciatic Nerve - anatomy & histology ; Surgery ; Testing ; Thigh - innervation</subject><ispartof>Surgical and radiologic anatomy (English ed.), 2018-11, Vol.40 (11), p.1267-1274</ispartof><rights>Springer-Verlag France SAS, part of Springer Nature 2018</rights><rights>Surgical and Radiologic Anatomy is a copyright of Springer, (2018). All Rights Reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c372t-fda773d96e5285c1f7ef7dfcebeae4bfd8012eccb76b2746928f751eadec61d53</citedby><cites>FETCH-LOGICAL-c372t-fda773d96e5285c1f7ef7dfcebeae4bfd8012eccb76b2746928f751eadec61d53</cites><orcidid>0000-0002-0155-7447</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00276-018-2094-1$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00276-018-2094-1$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,780,784,27923,27924,41487,42556,51318</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/30167824$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Kendir, S.</creatorcontrib><creatorcontrib>Torun, Bilge İpek</creatorcontrib><creatorcontrib>Akkaya, T.</creatorcontrib><creatorcontrib>Comert, A.</creatorcontrib><creatorcontrib>Tuccar, E.</creatorcontrib><creatorcontrib>Tekdemir, I.</creatorcontrib><title>Re-defining the anatomical structures for blocking the nerves in adductor canal and sciatic nerve through the same injection site: an anatomical study</title><title>Surgical and radiologic anatomy (English ed.)</title><addtitle>Surg Radiol Anat</addtitle><addtitle>Surg Radiol Anat</addtitle><description>Purpose
The aim of this study is to re-define the anatomical structures which are important for blocking the sciatic nerve and the nerves within the adductor canal which innervate the knee joint through the same injection site. We also aimed to investigate the spread of the anesthetic toward the areas in which the mentioned nerves lie on cadavers.
Methods
This study was performed on 16 lower extremities of formaldehyde-embalmed eight adult cadavers. The anatomy of adductor canal, courses of the nerves within the canal and the relationships of the saphenous, medial femoral cutaneous, medial retinacular, posterior branch of the obturator and sciatic nerves with each other and with the fascial compartments were investigated. Transverse sections that crossed the superior border of vastoadductor membrane were taken to reach the sciatic nerve in the shortest way. Colored latex was injected to demonstrate the anesthetic blockage of the targeted nerves. The structures along the needle’s way were investigated.
Results
The saphenous, medial femoral cutaneous and at its distal part posterior branch of the obturator nerve were colored with latex within the adductor canal. The nerve to vastus medialis (in other words, the medial retinacular nerve) lay beneath the fascia of vastus medialis and did not enter the adductor canal. There was a fascial plane which did not allow the passage of colored latex toward the sciatic nerve. To traverse this fascial structure, it was found out to be necessary to insert the needle perpendicular to both the vertical and transverse axes of the thigh and then advance it along 2/3 of diameter of the thigh. Thus, the colored latex was observed to fill the compartment where the sciatic nerve lay within.
Conclusions
Blocking the sciatic nerve and the nerves within the adductor canal which innervate the knee joint through the same injection site seems anatomically possible without injuring any neurovascular structures.</description><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Anatomic Landmarks</subject><subject>Anatomy</subject><subject>Cadaver</subject><subject>Cadavers</subject><subject>Dissection</subject><subject>Fascia</subject><subject>Female</subject><subject>Femoral Nerve - anatomy & histology</subject><subject>Femur</subject><subject>Humans</subject><subject>Imaging</subject><subject>Injection</subject><subject>Knee</subject><subject>Knee Joint - innervation</subject><subject>Latex</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Middle Aged</subject><subject>Nerve Block</subject><subject>Nerves</subject><subject>Obturator Nerve - anatomy & histology</subject><subject>Original Article</subject><subject>Orthopedics</subject><subject>Pilot Projects</subject><subject>Radiology</subject><subject>Sciatic nerve</subject><subject>Sciatic Nerve - anatomy & histology</subject><subject>Surgery</subject><subject>Testing</subject><subject>Thigh - innervation</subject><issn>0930-1038</issn><issn>1279-8517</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2018</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><recordid>eNp1kd9qFTEQh4Mo9rT6AN7IgjfeRGeyf5L1TopWoSCIXi_ZZHKa4-6mJlmhL-LzmtNtFQWvApnvm2Hmx9gzhFcIIF8nACE7Dqi4gL7h-IDtUMieqxblQ7aDvgaOUKsTdprSAQBaRPWYndSAnVSi2bGfn4lbcn7xy77KV1TpRecwe6OnKuW4mrxGSpULsRqnYL7dYwvFH-XfL5W2tlClboo6Fd9WyXidvdmggsew7q9utaRnKtKBTPZhqZLP9KYof09d7c0T9sjpKdHTu_eMfX3_7sv5B3756eLj-dtLbmopMndWS1nbvqNWqNagk-SkdYZG0tSMzipAQcaMshuFbLpeKCdbJG3JdGjb-oy93Ppex_B9pZSH2SdD06QXCmsaylmV7EQrjuiLf9BDWGNZ-ZaS5ezQ94XCjTIxpBTJDdfRzzreDAjDMbRhC20ooR29ZsDiPL_rvI4z2d_GfUoFEBuQSmnZU_wz-v9dfwELv6V1</recordid><startdate>20181101</startdate><enddate>20181101</enddate><creator>Kendir, S.</creator><creator>Torun, Bilge İpek</creator><creator>Akkaya, T.</creator><creator>Comert, A.</creator><creator>Tuccar, E.</creator><creator>Tekdemir, I.</creator><general>Springer Paris</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FE</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BHPHI</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>KB0</scope><scope>LK8</scope><scope>M0S</scope><scope>M1P</scope><scope>M7P</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-0155-7447</orcidid></search><sort><creationdate>20181101</creationdate><title>Re-defining the anatomical structures for blocking the nerves in adductor canal and sciatic nerve through the same injection site: an anatomical study</title><author>Kendir, S. ; Torun, Bilge İpek ; Akkaya, T. ; Comert, A. ; Tuccar, E. ; Tekdemir, I.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c372t-fda773d96e5285c1f7ef7dfcebeae4bfd8012eccb76b2746928f751eadec61d53</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2018</creationdate><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Anatomic Landmarks</topic><topic>Anatomy</topic><topic>Cadaver</topic><topic>Cadavers</topic><topic>Dissection</topic><topic>Fascia</topic><topic>Female</topic><topic>Femoral Nerve - anatomy & histology</topic><topic>Femur</topic><topic>Humans</topic><topic>Imaging</topic><topic>Injection</topic><topic>Knee</topic><topic>Knee Joint - innervation</topic><topic>Latex</topic><topic>Male</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Middle Aged</topic><topic>Nerve Block</topic><topic>Nerves</topic><topic>Obturator Nerve - anatomy & histology</topic><topic>Original Article</topic><topic>Orthopedics</topic><topic>Pilot Projects</topic><topic>Radiology</topic><topic>Sciatic nerve</topic><topic>Sciatic Nerve - anatomy & histology</topic><topic>Surgery</topic><topic>Testing</topic><topic>Thigh - innervation</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Kendir, S.</creatorcontrib><creatorcontrib>Torun, Bilge İpek</creatorcontrib><creatorcontrib>Akkaya, T.</creatorcontrib><creatorcontrib>Comert, A.</creatorcontrib><creatorcontrib>Tuccar, E.</creatorcontrib><creatorcontrib>Tekdemir, I.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>Biological Science Collection</collection><collection>ProQuest Central</collection><collection>Natural Science Collection</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>SciTech Premium Collection</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>ProQuest Biological Science Collection</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Biological Science Database</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><jtitle>Surgical and radiologic anatomy (English ed.)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Kendir, S.</au><au>Torun, Bilge İpek</au><au>Akkaya, T.</au><au>Comert, A.</au><au>Tuccar, E.</au><au>Tekdemir, I.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Re-defining the anatomical structures for blocking the nerves in adductor canal and sciatic nerve through the same injection site: an anatomical study</atitle><jtitle>Surgical and radiologic anatomy (English ed.)</jtitle><stitle>Surg Radiol Anat</stitle><addtitle>Surg Radiol Anat</addtitle><date>2018-11-01</date><risdate>2018</risdate><volume>40</volume><issue>11</issue><spage>1267</spage><epage>1274</epage><pages>1267-1274</pages><issn>0930-1038</issn><eissn>1279-8517</eissn><abstract>Purpose
The aim of this study is to re-define the anatomical structures which are important for blocking the sciatic nerve and the nerves within the adductor canal which innervate the knee joint through the same injection site. We also aimed to investigate the spread of the anesthetic toward the areas in which the mentioned nerves lie on cadavers.
Methods
This study was performed on 16 lower extremities of formaldehyde-embalmed eight adult cadavers. The anatomy of adductor canal, courses of the nerves within the canal and the relationships of the saphenous, medial femoral cutaneous, medial retinacular, posterior branch of the obturator and sciatic nerves with each other and with the fascial compartments were investigated. Transverse sections that crossed the superior border of vastoadductor membrane were taken to reach the sciatic nerve in the shortest way. Colored latex was injected to demonstrate the anesthetic blockage of the targeted nerves. The structures along the needle’s way were investigated.
Results
The saphenous, medial femoral cutaneous and at its distal part posterior branch of the obturator nerve were colored with latex within the adductor canal. The nerve to vastus medialis (in other words, the medial retinacular nerve) lay beneath the fascia of vastus medialis and did not enter the adductor canal. There was a fascial plane which did not allow the passage of colored latex toward the sciatic nerve. To traverse this fascial structure, it was found out to be necessary to insert the needle perpendicular to both the vertical and transverse axes of the thigh and then advance it along 2/3 of diameter of the thigh. Thus, the colored latex was observed to fill the compartment where the sciatic nerve lay within.
Conclusions
Blocking the sciatic nerve and the nerves within the adductor canal which innervate the knee joint through the same injection site seems anatomically possible without injuring any neurovascular structures.</abstract><cop>Paris</cop><pub>Springer Paris</pub><pmid>30167824</pmid><doi>10.1007/s00276-018-2094-1</doi><tpages>8</tpages><orcidid>https://orcid.org/0000-0002-0155-7447</orcidid></addata></record> |
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| identifier | ISSN: 0930-1038 |
| ispartof | Surgical and radiologic anatomy (English ed.), 2018-11, Vol.40 (11), p.1267-1274 |
| issn | 0930-1038 1279-8517 |
| language | eng |
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| source | MEDLINE; SpringerLink Journals - AutoHoldings |
| subjects | Aged Aged, 80 and over Anatomic Landmarks Anatomy Cadaver Cadavers Dissection Fascia Female Femoral Nerve - anatomy & histology Femur Humans Imaging Injection Knee Knee Joint - innervation Latex Male Medicine Medicine & Public Health Middle Aged Nerve Block Nerves Obturator Nerve - anatomy & histology Original Article Orthopedics Pilot Projects Radiology Sciatic nerve Sciatic Nerve - anatomy & histology Surgery Testing Thigh - innervation |
| title | Re-defining the anatomical structures for blocking the nerves in adductor canal and sciatic nerve through the same injection site: an anatomical study |
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