The anatomy and clinical implications of the obturator nerve and its branches

Abstract

The obturator nerve sends both motor and sensory fibres to the medial compartment of the thigh. This study aimed to provide a clear description of the anatomy and course of the obturator nerve and its branches to assist surgeons and clinicians in the safe performance of various pelvic procedures One hundred and one (101) formalin-fixed cadavers 61 males and 40 females (68 ± 17 years), were dissected at the Department of Anatomy, University of Pretoria. Dissections were performed just lateral to the lumbar vertebra to describe the origin of the obturator nerve. The course of the nerve, with its relations, was observed and recorded until it terminated in the medial thigh. The location of the obturator nerve within the obturator foramen was quantified by measuring the distance from three (3) bony landmarks of the obturator foramen to the nerve; most superior, most medial and most inferior points. The results were used to determine their possible clinical applications. Variations were observed in the root origins of the obturator nerve, its course in the abdomen, bifurcation patterns and the innervation patterns of its terminal branches. The obturator nerve (B) was found 6.26 ± 1.62 mm from the most superior point (A), 31.69 ± 3.41 mm from the most medial point (C) and 47.33 ± 3.94 mm from most inferior point (D). The measurement from the obturator nerve to the most inferior point (B-D) is the one with a significant difference for sex (p = 0.26). The results may be used in the pre-operative preparation of pelvic lymphadenectomy, stress urinary incontinence (SUI) treatment and obturator nerve blocks. The study has assisted in expanding the knowledge on the anatomy of the obturator nerve and its branches in a South African context. These results should be verified in a clinical setting.