SSural nerve: anatomical study and clinical aspects.

Abstract

Introduction: An anatomical study of the sural nerve in 20 fresh cadavers was carried out, with the main aim of knowing the anatomy of the sural nerve and the relationships with the anatomical points to facilitate its identification in different clinical and surgical procedures. Materials and methods: From fresh cadavers with ages between 20 and 40 years and less than 48 hours of death, 20 legs were studied. Through a posterior incision the sural nerve was dissected from the popliteal region until the lateral malleolus, identifying the medial sural cutaneous nerve and the communicating branch of the common peroneal nerve. Measures were made in centimeters. Results: In 70% of the cases, the sural nerve was composed by the connection of the medial sural cutaneous nerve and the communicating branch of the common peroneal nerve and in 30% only by the medial sural cutaneous nerve. This branch was present in 100% of the cases. The communicating branch was present without connection with the medial sural cutaneous nerve in 15%, and in the other 15% this branch was absent. In 57% the nervous connection was proximal to the miotendinous union of the gastrocnemius The width of the miotendinous union of the gastrocnemius were between 5 to 8 cm (average 6.5 cm). The sural nerve was found 2.6 cm on average medial to the lateral border of the union. In the 6 cases of connection distal to the miotendinous union, the sural medial nerve passed 2 cm in average medial to the lateral border of the union, and the sural lateral to 0.8 cm medial of the same reference mentioned. Regarding the insertion of the Achilles’ tendon, the sural nerve passed 2.25 cm previous to the same and in relation to the most prominent and posterior part of the lateral malleolus it passed 2 cm in average. Discussion: This study showed that is possible to find the sural nerve with security if the anatomical points are identified well to preserve it in different surgeries or to harvest the flaps in neurological studies and harvesting it for grafting or nerve biopsy.