The obturator nerve emerges from the medial border of the psoas, crosses the pelvic brim, and passes through the obturator foramen to reach the medial thigh where it divides into anterior and posterior divisions that supply the adductor muscles. It is the primary motor nerve to the medial thigh adductors and is susceptible to injury during pelvic surgery, obturator hernia repair, and prolonged labour.
| Origin | Lumbar plexus (L2, L3, L4) |
|---|---|
| Course | Descends through the psoas muscle, exits the pelvis through the obturator foramen, and divides into anterior and posterior divisions in the medial thigh |
| Motor | |
| Sensory |
|
Obturator nerve injury produces adductor weakness causing a wide-based gait and difficulty crossing the legs, combined with sensory loss over the medial thigh. Obturator nerve entrapment syndrome is an important and underrecognised cause of groin pain in athletes, producing medial thigh pain during exercise that radiates to the knee and is reproduced by adductor contraction. Obturator neurectomy is occasionally performed for intractable adductor spasticity in cerebral palsy.
Compression of the nerve at the obturator foramen in athletes producing exertional medial thigh pain radiating to the knee that is reproduced by adductor contraction and relieved by rest.
Injury during pelvic surgery or obturator hernia producing adductor weakness and medial thigh sensory loss with a waddling, wide-based gait.
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