Anat Cell Biol.  2014 Jun;47(2):144-147. 10.5115/acb.2014.47.2.144.

Fascial entrapment of the sural nerve and its clinical relevance

• Paraskevas GK
• Natsis K
• Tzika M
• Ioannidis

• KMID: 1882588
• DOI: http://doi.org/10.5115/acb.2014.47.2.144

Abstract

Sural nerve presents great topographic variability and it is responsible for sensory innervation of the posterolateral side of the distal third of the leg and lateral aspect of the foot. Entrapment of the nerve could be caused by compression due to fascial thickening, while the symptomatology includes sensory alterations and deficits at the nerve distribution area. We report a cadaveric case of a variant sural nerve that presented a distinct entrapment site. A supernumerary sensory branch was encountered originating from the common peroneal nerve, while the peroneal component of the sural nerve was observed to take a course within a fibrous fascial tunnel 3.1 cm in length that caused nerve fixation and flattening. The tension applied to the aforementioned branch was shown to worsen during passive forcible foot plantaflexion and inversion. The etiology, diagnosis and the treatment options are discussed comprehensively.

Keyword

Sural; Entrapment; Fascia; Tunnel

MeSH Terms

Cadaver
Diagnosis
Fascia
Foot
Leg
Peroneal Nerve
Sural Nerve*

Figure

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  Fig. 1 Entrapment of the anastomotic peroneal branch of the sural nerve. The anastomotic peroneal branch (PB) of the sural nerve was found entrapped in a fibrous fascial tunnel (FT). D, distal; L, lateral; M, medial; P, proximal; SSV, small saphenous vein.

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  Fig. 2 Supernumerary sensory nerve originating from the common peroneal nerve. A second sensory nerve branch (*) was observed originating from the common peroneal as a separate trunk lying underneath the crural fascia and medially to the anastomotic peroneal branch (PB) of the sural nerve. D, distal; L, lateral; M, medial; P, proximal; SSV, small saphenous vein.

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  Fig. 3 Formation of the sural nerve. The sural nerve is formed by the anastomotic peroneal branch (PB) and the medial sural nerve (mSN) at the distal 1/3 of the leg. D, distal; L, lateral; M, medial; P, proximal; SSV, small saphenous vein. Circle, formation point; *, supernumerary sensory nerve.

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