Yonsei Med J.  2006 Jun;47(3):415-422. 10.3349/ymj.2006.47.3.415.

The Relative Contributions of the Medial Sural and Peroneal Communicating Nerves to the Sural Nerve

• Kim CH
• Jung HY
• Kim MO
• Lee CJ

• KMID: 1715862
• DOI: http://doi.org/10.3349/ymj.2006.47.3.415

Abstract

The medial sural cutaneous nerve (MSCN) and peroneal communicating nerve (PCN) conjoin in the calf area to form the sural nerve (SN). In previous anatomic studies, there was unresolved debate as to the main contributor to the sural nerve, and the relative contributions of MSCN and PCN had not been studied. The purpose of this study is to determine their relative neurophysiologic contributions to the SN by nerve conduction study (NCS). A total of 47 healthy subjects (25 males and 22 females, mean age 29.6+/-10.4 yrs, range 20-59 yrs) participated in the study. This study employed the orthodromic nerve conduction technique: stimulation at the ankle and recording at the mid calf (SN); specifically, we preformed stimulation at the mid calf (MSCN, PCN) and recording at 14cm proximal to the middle of the popliteal fossa (MSCN) and fibular head (PCN). The onset and peak latencies (ms) were SN 2.3+/-0.2 and 3.0+/-0.2; MSCN 2.1+/-0.2 and 2.8+/-0.2; and PCN 2.1+/-0.2 and 2.8+/-0.2. The peak-to-peak amplitudes (micro) and areas (nVsec) of the SN, MSCN, and PCN were 9.7+/-3.9, 7.0+/-4.7, and 5.0+/-3.2; and 7.2+/-2.9, 5.7+/-3.4, and 4.0+/-2.4, respectively. The side-to-side difference was not statistically significant. The main contributor to the SN was found to be the MSCN. The relative contribution ratio of the MSCN to the PCN was 1.37:1 by amplitude and 1.42:1 by area. However, in 32.9% of the subjects, the contribution of the PCN was greater than that of the MSCN.

Keyword

Sural nerve; contribution ratio; nerve conduction study; medial sural cutaneous nerve; peroneal communicating nerve

MeSH Terms

Sural Nerve/*anatomy & histology/*physiology
Peroneal Nerve/*anatomy & histology/*physiology
Neural Conduction/*physiology
Middle Aged
Male
Humans
Female
Adult

Figure

• 

  Fig. 1 Wave form markers: 1, onset latency; 2, peak latency; time from marker 1-3, duration; vertical distance from 1 (or 2)-3, peak to peak amplitude; area under the curve, from marker 1-3.

• 

  Fig. 2 Waveforms from the SN (upper trace), MSCN (middle trace), and PCN (lower trace). The values are DIST (distance), LAT (peak latency), CV (conduction velocity), and AMP (amplitude).

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  Fig. 3 The onset and peak latencies of the SN, MSCN and PCN. 1; the onset latency of the SN, 2; the onset latency of the MSCN, 3; the onset latency of the PCN, 4; the peak latency of the SN, 5; the peak latency of the MSCN, 6; the peak latency of the PCN.

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  Fig. 4 The amplitudes and areas of the SN, MSCN and PCN. 1; the amplitude of the SN, 2; the amplitude of the MSCN, 3; the amplitude of the PCN, 4; the area of the SN, 5; the area of the MSCN, 6; the area of the PCN.

• 

  Fig. 5 The side-to-side difference for onset and peak latencies. 1; the onset latency of the SN, Rt. 2; the onset latency of the SN, Lt. 3; the onset latency of the MSCN, Rt. 4; the onset latency of the MSCN, Lt. 5; the onset latency of the PCN, Rt. 6; the onset latency of the PCN, Lt. 7 the peak latency of the SN, Rt. 8; the peak latency of the SN, Lt. 9; the peak latency of the MSCN, Rt. 10; the peak latency of the MSCN, Lt. 11; the peak latency of the PCN, Rt. 12; the peak latency of the PCN, Lt.

• 

  Fig. 6 The side-to-side difference for amplitudes and areas. 1; the amplitude of the SN, Rt. 2; the amplitude of the SN, Lt. 3; the amplitude of the MSCN, Rt. 4; the amplitude of the MSCN, Lt. 5; the amplitude of the PCN, Rt. 6; the amplitude of the PCN, Lt. 7; the area of the SN, Rt. 8; the area of the SN, Lt. 9; the area of the MSCN, Rt. 10; the area of the MSCN, Lt. 11; the area of the PCN, Rt. 12; the area of the PCN, Lt.

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  Fig. 7 The correlation of the sum amplitude with that of the SN. (r = 0.692, p < 0.01). Sum amplitude = sum amplitude of the MSCN and the PCN.

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  Fig. 8 The correlation of the sum area with the area of the SN. (r = 0.658, p < 0.01). Sum area = sum area of the MSCN and the PCN.

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