The Association between Anatomical Variants of Musculoskeletal Structures and Nerve Compressions of the Lower Limb: A Systematic Review and Meta-Analysis

Abstract

Objective: The aim of this study was to describe the main anatomical variants and morphofunctional alterations in the lower limb that compress surrounding nervous structures in the gluteal region, thigh region, and leg and foot region. Methods: We searched the Medline, Scopus, Web of Science, Google Scholar, CINAHL, and LILACS databases from their inception up to October 2023. An assurance tool for anatomical studies (AQUA) was used to evaluate methodological quality, and the Joanna Briggs Institute assessment tool for case reports was also used. Forest plots were generated to assess the prevalence of variants of the gluteal region, thigh, and leg. Results: According to the forest plot of the gluteal region, the prevalence was 0.18 (0.14–0.23), with a heterogeneity of 93.52%. For the thigh region, the forest plot presented a prevalence of 0.10 (0.03–0.17) and a heterogeneity of 91.18%. The forest plot of the leg region was based on seven studies, which presented a prevalence of 0.01 (0.01–0.01) and a heterogeneity of 96.18%. Conclusions: This review and meta-analysis showed that, in studies that analyzed nerve compressions, the prevalence was low in the thigh and leg regions, while in the gluteal region, it was slightly higher. This is mainly due to the PM region and its different variants. We believe that it is important to analyze all the variant regions defined in this study and that surgeons treating the lower limb should be attentive to these possible scenarios so that they can anticipate possible surgical situations and thus avoid surgical complications.

Keywords

• lower extremity
• nerve compressions
• sciatic nerve
• femoral cutaneous nerve
• fibular nerve
• neural entrapment