The posterior cutaneous nerve of the thigh is a large purely sensory nerve supplying the entire posterior thigh skin from the gluteal fold to the popliteal fossa. It runs in the deep fascia of the posterior thigh alongside the long head of the biceps femoris and provides sensation to an area frequently affected by ischaemia from prolonged sitting or surgical positioning. Post-surgical meralgia from hip arthroplasty and prolonged lithotomy position can affect this nerve.
| Origin | Sacral plexus (S1, S2, S3) |
|---|---|
| Course | Exits the pelvis through the greater sciatic foramen below the piriformis, descends in the posterior thigh to the knee, and gives off inferior cluneal and perineal branches proximally |
| Sensory |
|
Posterior thigh numbness from posterior cutaneous nerve of the thigh injury or compression is a recognised complication of prolonged lithotomy positioning in gynaecological and urological surgery, from ischaemia of the nerve from the gluteal fold compression against the table edge. Most cases recover spontaneously when the pressure is removed. Pudendal nerve injury from similar positioning accompanies posterior cutaneous nerve compression in some cases.
Posterior cutaneous nerve compression from prolonged lithotomy position producing posterior thigh and perineal numbness, usually resolving spontaneously.
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