Title: A REVIEW OF TWENTY CASES OF OBTURATOR ENTRAPMENT NEUROPATHY AS A CAUSE OF GROIN PAIN 33
Abstract: This paper reviews twenty cases of obturator nerve entrapment which presented to a sports medicine centre over a period of twelve months. All cases presented with groin pain which was exercise-related. The majority of the cases were in male athletes, with one subject being female. The majority of cases presented were Australian Rules footballers, whilst soccer players, competitive runners and track athletes were also represented. The typical pain of obturator nerve entrapment is pain which is felt deep in the groin and centred upon the adductor origin. With exercise, the pain radiates down the inner thigh to the medial knee. Occasionally there is radiation of the pain to the ipsilateral anterior superior iliac spine. The pain is often associated with a sensation of weakness in the affected limb, particularly with kicking or with jumping. Examination findings at rest are often unremarkable, but examination post-exercise reveals weakness of resisted adduction and parasthesia on the distal medial thigh. Radio-isotope scintigraphy shows increased uptake over the ipsilateral pubis, and needle electromyographic studies show slowing of the obturator nerve conduction. The diagnosis can be confirmed with x-ray guided injection of the obturator nerve. Conservative treatment can include deep fascial release massage, pectineus stretches, neuromeningeal stretches and occasionally corticosteroid injection around the obturator nerve. Surgical treatment involves division of the adductor brevis fascia, and decompression of the obturator nerve as it passes through the obturator foramen.