Annals of Rehabilitation Medicine

"Femoral nerve"

Original Articles

Effect of Fascia Penetration in Lateral Femoral Cutaneous Nerve Conduction: Mi-Jeong Yoon, Hye Min Park, Sun Jae Won; Ann Rehabil Med 2020;44(6):459-467. Published online December 31, 2020; DOI: https://doi.org/10.5535/arm.20022

Abstract
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Objective
To evaluate the effect of fascia penetration and develop a new technique for lateral femoral cutaneous nerve (LFCN) conduction studies based on the fascia penetration point (PP) identified using ultrasound.
Methods
The fascia PP of the LFCN was localized in 20 healthy subjects, and sensory nerve action potentials (SNAPs) were obtained at four different stimulation points—2 cm proximal to the PP (2PPP), PP, 2 cm distal to the PP (2DPP), and 4 cm distal to the PP (4DPP). We compared the stimulation technique based on the fascia penetration point (STBFP) with the conventional technique.
Results
The SNAP amplitude of the LFCN was significantly higher when stimulation was performed at the PP and 2DPP than at other stimulation points. Using the STBFP, SNAP responses were elicited in 38 of 40 legs, whereas they were elicited in 32 of 40 legs using the conventional technique (p=0.041). STBFP had a comparable SNAP amplitude and slightly delayed negative peak latency compared to the conventional technique. In terms of the time required, the time spent on STBFP showed a more consistent distribution than the time spent on the conventional technique (two-sample Kolmogorov–Smirnov test, p<0.05).
Conclusion
SNAP of the LFCN significantly changed near the fascia PP, and stimulation at PP and at 2DPP provided high amplitudes. STBFP can help increase the response rate and ensure stable and consistent procedure time of the LFCN conduction study.

Citations

Citations to this article as recorded by

Meralgia Paresthetica as a Result of Surgery With an Emphasis on Harvesting Iliac Bone Grafts: A Review
Sonia N. Singh, Ruby R. Taylor, Chaimae Oualid, Mutaz B. Habal, Seth R. Thaller
Journal of Craniofacial Surgery.2024; 35(7): 1964. CrossRef
Dorsal ulnar cutaneous nerve conduction study based on nerve ultrasound
Eunjin Park, So-youn Chang, Hye Jung Park, Ho-geon Namgung, Sun Jae Won
Scientific Reports.2024;[Epub] CrossRef

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Femoral Nerve Block (Motor Branch of Rectus Femoris) for Stiff-legged Gait in Spastic Patients.: Sung, Duk Hyun , Bang, Heui Je; J Korean Acad Rehabil Med 1999;23(1):37-45.

Abstract
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Objective: To verify the effectiveness of nerve block to the femoral nerve (motor branch of rectus femoris) for stiff-legged gait in spastic patients and to identify factors which influence its effect.

Method: EMG-guided femoral nerve (motor branch of rectus femoris) block by 2% lidocaine and/or 5% phenol was performed on 33 patients with stiff-legged gait: 22 were spastic hemiplegia after stroke; 10 were spastic paraparesis; 1 was spastic diplegia. Subjective improvement in gait performance was evaluated. Pre- and post-block comparisons were made by objective parameters, including gait speed and sagittal knee kinematics.

Results: Twenty five of all subjects showed subjective improvement in gait performance and significant differences of pre- and postblock gait data after nerve block by 2% lidocaine. Eighteen of 19 patients who had activity of rectus femoris alone at swing phase showed subjective improvement in gait performance and significant differences of pre- and postblock gait data after this procedure. Twenty two of 25 patients with sufficient strength of hip flexor showed the same result as the above. There were no significant differences between the subgroups depending on the degree of the quadriceps spasticity. 5% phenol block for more long-term effect also showed significant increase in knee flexion at swing phase in these 25 patients.

Conclusion: Femoral nerve (motor branch of rectus femoris) block can be a effective treatment modality for stiff-legged gait. Sufficient strength of hip flexor muscle, rectus femoris activity without activities of vastus muscles at swing phase on dynamic EMG are the factors which predict the favorable outcome in this procedure. But, diagnostic block with lidocaine is a mandatory to predict its effect in clinical practice.