Femoral neuropathy is an uncommon complication of hemorrhagic disorders. Little direct evidence exists concerning the responsible pathomechanics for it.1-9 The two mechanisms of injury which have been postulated are hemorrhage into the nerve,3,5,7,10 and compression by hemorrhage within the iliopsoas muscle.2-4,8 The latter mechanism is based on anatomical features, but has not been demonstrated to have occurred with hemorrhage distal to the inguinal ligament.11 The present case report provides this demonstration.
The femoral nerve passes distally and laterally from behind the psoas muscle to lie deep to the iliacus fascia, in the groove between the psoas and the iliacus muscles. The femoral nerve divides into its terminal branches at or just below the inguinal ligament. Thus, the femoral nerve lies in a closed fascial compartment with the psoas and iliacus muscles and leaves the pelvis through a fibro-osseous tunnel bounded by the inguinal ligament, the pubic
Kettlekamp DB, Powers SR. Femoral Compression Neuropathy in Hemorrhagic Disorders. Arch Surg. 1969;98(3):367-368. doi:10.1001/archsurg.1969.01340090143027