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Case Report The femoral nerve is the largest branch of the lumbar plexus. It arises from the dorsal branches of second to fourth ventral rami. Conventionally the femoral nerve passes behind the inguinal ligament and divides into anterior and posterior divisions in the thigh. Aberrant slip of iliacus or psoas major muscle sometimes splits the femoral nerve. The detailed knowledge of the possible variations of these muscles and femoral nerve may have immense importance in various pelvic and pelvi-femoral surgeries. The femoral nerve was studied during routine undergraduate cadaveric dissection performed in the department of Anatomy, KCGMC, Karnal. We observed a rare variation in the course of femoral nerve on the left side. The femoral nerve was found to split into two divisions above the inguinal ligament after its origin from the lumbar plexus by two slips of iliacus muscle. The lower division of the nerve passed deep to the slips of iliacus muscle fibres and the upper division ran superficial to iliacus muscle deep to fascia iliaca. Both the divisions joined after entrapping the slips of iliacus muscle just above the inguinal ligament to form the trunk of the femoral nerve. Another variation noted in the present case was that lateral cutaneous nerve of thigh arose directly from the femoral nerve. In the cases of femoral nerve paralysis, neuropathy caused by iliac hematoma after anticoagulant treatment or vessel catheterization, the existence of some variant muscles or variations in formation and branching pattern of the femoral nerve may increase the chances of nerve compression. Origin of lateral cutaneous nerve of thigh from the femoral nerve may have impact on the clinical efficacy of lumbar plexus blockade, since femoral nerve blockade is likely to produce blockade in the area of distribution of lateral cutaneous nerve of thigh in these plexuses. These variations are of significant practical importance for the surgeons to prevent further surgical complications during routine surgery.

Anatomical Variations in Formation and Branching Pattern of the Femoral Nerve in Iliac Fossa