Saphenous Nerve Pain Symptoms And Entrapment Treatment?

The saphenous nerve (n. saphenous; long or internal saphenous nerve) is the largest cutaneous branch of the femoral nerve and It is a strictly sensory nerve and has no motor function.

Description: Saphenous Nerve

Saphenous Nerve: Innervation of the Leg and Foot

• arises from the femoral nerve in the femoral triangle and descends through it on the lateral side of the femoral vessels to enter the adductor canal.
• it crosses the vessels obliquely to lie on their medial facet before of lower finish of striated muscle Magnus muscle
• it crosses the vessels obliquely to lie on their medial side in front of lower end of adductor Magnus muscle
• the nerve continues its descent on the medial side of the knee, pierces fascia lata between tendons of sartorius & gracilis, & then passes downward on the medial side of the leg close to the greater saphenous vein.
• at the lower end of the canal, it leaves femoral vessels & gives off its infrapatellar branch, & runs onward to supply the skin over medial side and front of the knee and patellar ligament the saphenous nerve lies posterior to sartorius in 60%;

Sartorial Branch: lies posterior to the sartorius;
Infrapatellar Branch: the nerve exits the adductor muscle canal and travels to the anteromedial facet of the knee;

Position Relative To The Fascia:

• at the amount of the knee the nerve is further fascial in forty-third within the lower leg, it subdivides:
• one branch follows the medial leg bone border to the amount of the articulatio talocruralis.
• larger passes anterior to medial malleolus to innervate skin on medial and dorsal aspect foot;

Changes In Nerve Position w/ Knee Flexion:

• in extension, nerve & all infrapatellar branches cross-medial joint line anterior to posteromedial corner & are situated 2-3 cm
  anterior to semitendinosus tendon;
• within the flexed knee, nerve and its branches cross-medial joint line at, or slightly behind, posteromedial corner of the knee;

A saphenous Nerve Block or Sapherous Block

• provides anesthesia over the medial portion of the foot;
• body covering “field block” with continuous trauma from the lateral margin of the tendon around the anterior articulatio talocruralis to the medial margin of the tendon can anesthetize all superficial nerves of the foot: superficial leg bone, saphenous, and sural;

What Does The Saphenous Nerve Innervate

It approaches the arteria wherever this vessel passes to a lower place the musculus sartorius, and lies before of the artery, behind the fascia covering of the striated muscle canal, as way because of the gap within the lower a part of the striated muscle Magnus.

Here it diverges from the artery, and emerges from behind the lower fringe of the fascia covering of the canal; it descends vertically on the medial aspect of the knee behind the musculus sartorius, pierces the facia lata, between the tendons of the musculus sartorius and Gracilis, and becomes connective tissue.

The nerve then passes on the leg bone aspect of the leg, amid the nice vein, descends behind the medial border of the leg bone, and, at the lower third of the leg, divides into two branches:

• one continues its course on the margin of the leg bone and ends at the ankle joint.
• the other passes before the ankle joint and is distributed to the skin on the medial aspect of the foot, as way because of the ball of the nice toe, communication with the medial branch of the superficial leg bone nerve.

Saphenous Nerve Function

The saphenous nerve, regarding the center of the thigh, gives off a branch that joins the sub-sartorial plexus.

At the medial aspect of the knee, it gives off a large infrapatellar branch, that pierces the sartorius and fascia lata, and is distributed to the skin in front of the patella.

Below the knee, the branches of the nerve (medial crural cutaneous branches) are distributed to the skin of the front and medial aspect of the leg, communicating with the cutaneous branches of the femoral, or with filaments from the obturator (prosthesis) nerve.

Pain, Invasive Procedures For Saphenous Nerve Block

Anatomy
The saphenous nerve is the largest branch of the femoral nerve and innervates the medial portion of the lower leg and therefore the foot. furthermore, The nerve travels with the femoral artery through Hunter’s canal, and at the medial condyle of the distal femur, it provides the medial portion of the knee and therefore the lower leg.

Indications
The saphenous nerve block is beneficial in managing medial knee and leg pain. furthermore, This nerve can become entrapped within Hunter’s canal as it courses through striated muscle Magnus’s muscle.

Procedure
Two approaches have been described, first at the ankle and the second above the knee joint. therefore, For the approach at the knee, the patient is supine with the leg outwardly rotated. when Hunter’s canal is known superior to the medial condyle of the femur, a needle is slowly advanced approximately 0.25–0.5 in. Either paresthesia can be elicited or a nerve stimulator may be used for accurate identification of needle placement. Following acceptable positioning and aspiration, the specified answer is injected.

Complications
Because of the proximity of the bigger saphenous artery, the postprocedure hematoma is common. then, the Needle-induced trauma can lead to postprocedure paresthesia.

Saphenous Nerve Pain Symptoms

Symptoms of the nerve saphenous entrapment may include knee pain, deep thigh ache, nerve leg, and paresthesias in the nerve’s cutaneous distribution in the leg and foot. The infrapatellar branch could become entrapped on its own as a result of it passes through a separate opening within the sartorius muscle sinew. it’s going to even be exposed to trauma wherever it runs horizontally across the prominence of the medial limb outgrowth. Patients report paresthesias and symptoms within the infrapatellar region that worsen with knee flexion or compression by clothes or braces.

Saphenous Nerve Entrapment Treatment

Saphenous nerve entrapment may be an oftentimes unmarked reason for persistent medial knee pain in patients who expertise trauma or direct blows to the medial aspect of the knee. as a result of the nervus saphenous is solely sensory, Associate in Nursing isolated injury to the present nerve mustn’t end in weakness.