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Sural Nerve

 
  • sensory nerve formed by the medial sural nerve (branch of the tibial nerve) and lateral sural nerve(branch of the common peroneal nerve).
  • Courses between the heads of the gastrocnemius, eventually emerging though the gastrocs fascial covering. Travels in the superfical posterior compartment of the leg. It crosses near the midline at the level of the musculotendinous junction of the achilles (@9.8 cm from the calcaneus) before descending to its more lateral location distally. At the level of insertion of the Achilles into the calcaneus, the sural nerve is 18.8 mm from the lateral border of the Achilles tendon.   (Webb J, Foot ankle Int 2000;21:475).
  • The sural nerve supplies lateral calcaneal branches to the heel, then descends 1-1.5 cm behind the lateral malleolus, anterolateral to the short saphenous vein suppling sensation to the lateral malleolus, Achilles tendon, and the ankle joint.
  • The sural nerve continues on the lateral aspect of the foot supplying sensation to the skin, subcutaneous tissue, fourth interosseous space, and the fifth toe.
  • Can be injured during surgery for Achilles tendon rupture.
  • Injected during ankle block.
  • Travels with the Lesser Saphenous during much of its course in the leg.