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Single incision approach for femoral–obturator nerve transfers: concept, technique and clinical case example
Poster
Talk Description

Institution: Monash University - VIC, Australia

SINGLE INCISION APPROACH FOR FEMORAL–OBTURATOR NERVE TRANSFERS: CONCEPT, TECHNIQUE AND CLINICAL CASE EXAMPLE Xavier DONG¹, Scott FERRIS2 ¹Victorian Plastic Surgery Unit, East Melbourne, Australia 2Monash University, Clayton, Australia Background: Obturator nerve injury is a recognised complication of intrapelvic and orthopaedic procedures. Conventional strategies, including intrapelvic repair and nerve grafting, are limited by the nerve’s deep anatomical location and prolonged regeneration distance. Nerve transfer for proximal lower limb injuries is an emerging alternative. Objectives: To describe a single-incision technique using femoral nerve outflow to reconstruct an obturator nerve deficit and to demonstrate its anatomical and clinical feasibility. Methods: A focused literature review was performed to define the anatomy of the sartorius nerve supply. A clinical case of a 49-year-old female with hip adduction weakness following laparoscopic hysterectomy is presented. The surgical technique for sartorius branch transfer to the obturator nerve is described in detail. Findings: Anatomical analysis demonstrated multiple sartorius nerve branches with sufficient length to reach the obturator nerve, allowing a tension-free coaptation through a single medial femoral triangle incision. At 12-month follow-up, the patient achieved near-normal hip adduction with no residual functional impairment. Conclusions: Sartorius branch femoral-to-obturator nerve transfer is a feasible and effective reconstructive option for obturator nerve palsy. The single-incision approach offers anatomical simplicity and avoids the morbidity of more proximal intrapelvic exposure. Both femoral-to-obturator and obturator-to-femoral transfers can be reliably performed through a strategically placed medial femoral incision.
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Dr Xavier Dong - , A/Prof Scott Ferris -

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