The Sural Nerve


	Head and Neck

	Vagus (X)

	Spinal Accessory Nerve (XI)

	Cervical Plexus (C2-4)

	Brachial Plexus (C5-T1)

	Upper Extremity

	Musculocutaneous

	Radial

	Median

	Ulnar

	Lower Extremity

	Ilioinguinal / Iliohypogastric

	Femoral

	Sciatic

	Common Peroneal

	Tibial

	Sural

The Sural Nerve in the Leg (prone)

Prior reports of ultrasound imaging of the sural nerve are limited. The sural nerve provides sensory innervation to the lateral aspect of the heel and foot and is sometimes used for nerve biopsy or harvest. The sural nerve usually forms from tibial (medial) and common peroneal (lateral) components, but anatomic variation is common.

A sural contribution from the tibial nerve can be imaged between the medial and lateral heads of the gastrocnemius muscles. The sural nerve emerges between these muscles to pierce the fascia lata and join the lesser saphenous vein within the subcutaneous tissue of the lateral aspect of the lower leg (Video 1.4 MB).

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References

Simonetti S, Bianchi S, Martinoli C. Neurophysiological and ultrasound findings in sural nerve lesions following stripping of the small saphenous vein. Muscle Nerve. 1999 Dec;22(12):1724-6. PMID: 10567089

Solomon LB, Ferris L, Tedman R, Henneberg M. Surgical anatomy of the sural and superficial fibular nerves with an emphasis on the approach to the lateral malleolus. J Anat. 2001 Dec;199(Pt 6):717-23. PMID: 11787825

Coert JH, Dellon AL. Clinical implications of the surgical anatomy of the sural nerve. Plast Reconstr Surg. 1994 Nov;94(6):850-5. PMID: 7972432