Sural Communicating Branch Of The Common Peroneal Nerve
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The sural communicating nerve ''(SCN)'' (''peroneal communicating branch'' of the
common fibular nerve The common fibular nerve (also known as the common peroneal nerve, external popliteal nerve, or lateral popliteal nerve) is a nerve in the lower leg that provides sensation over the posterolateral part of the leg and the knee joint. It divides at ...
) is a separate and independent nerve from both the medial and lateral sural cutaneous nerves, often arising from a common trunk of the
common fibular nerve The common fibular nerve (also known as the common peroneal nerve, external popliteal nerve, or lateral popliteal nerve) is a nerve in the lower leg that provides sensation over the posterolateral part of the leg and the knee joint. It divides at ...
The primary purpose of the sural communicating branch is to provide the structural path for transferring tibial nerve fascicular components to the
sural nerve The sural nerve ''(L4-S1)'' is generally considered a pure cutaneous nerve of the posterolateral leg to the lateral ankle. The sural nerve originates from a combination of either the sural communicating branch and medial sural cutaneous nerve, or ...
.


Anatomy

The ''sural communicating nerve'' (colloquially the peroneal communicating nerve) is one of the components of th
sural nerve complex
( MSCN, LSCN,SCN). It travels in an inferomedial direction from its origins either as a terminal component of the LSCN or is considered a nerve that originates along a common trunk of the lateral sural cutaneous nerve. This particular nerve is best described by Dr. Huelke in 1958. ''Dr. Huelke'' took the original modern cadaveric studies (from the turn of the 20th century) and wrote a treatise titled "The origin of the peroneal communicating nerve" that describes the origins and pathways of the peroneal communicating nerve. He did this research in such a way that would today be called a systematic review with the addition of his own cadaveric samples. He reported that the peroneal communicating nerve was only considered named if it 'originated from the lateral sural cutaneous nerve to anastomose with the medial sural cutaneous nerve' to form the sural nerve proper. ''Huelke'' found of the 159 samples that the peroneal communicating nerve arose from the common peroneal nerve with the lateral sural cutaneous nerve around 58.5% of the time and originated separately from the common peroneal nerve the remaining 41.5% of the time. In fact, Huelkes work is directly observed and fortified in a recent cadaveric study by Steele et al in which further origins of the sural communicating nerve arise lending the name nerve over branch, however even now there is no firm definition of the communication from the common peroneal nerve or from the lateral sural cutaneous nerve . Steele et al found that the sural communicating branch originated from the common peroneal nerve 50.79%, common trunk 16.67%, the lateral sural cutaneous nerve 30.16%, and sciatic nerve 2.38% of the 126 total samples that contained a sural communicating branch.


Essential component to the Sural Nerve Complex

The
sural nerve complex The sural nerve complex are the contributing nerves that form the sural nerve. There are eight documented anatomic variations of the sural nerve complex. Origins In 1987, an orthopedic surgeon named Dr. Ortiguela of the Mayo Clinic conducted a c ...
was first used by
Mayo Clinic The Mayo Clinic () is a nonprofit American academic medical center focused on integrated health care, education, and research. It employs over 4,500 physicians and scientists, along with another 58,400 administrative and allied health staff, ...
orthopedic surgeon Orthopedic surgery or orthopedics ( alternatively spelt orthopaedics), is the branch of surgery concerned with conditions involving the musculoskeletal system. Orthopedic surgeons use both surgical and nonsurgical means to treat musculoskeletal ...
Dr. Ortiguela in a 1987 cadaveric study of the contributing nerves that is the genesis before the sural nerve moves from deep
fascia A fascia (; plural fasciae or fascias; adjective fascial; from Latin: "band") is a band or sheet of connective tissue, primarily collagen, beneath the skin that attaches to, stabilizes, encloses, and separates muscles and other internal organs. ...
of the
gastrocnemius The gastrocnemius muscle (plural ''gastrocnemii'') is a superficial two-headed muscle that is in the back part of the lower leg of humans. It runs from its two heads just above the knee to the heel, a three joint muscle (knee, ankle and subtalar ...
into the subcutaneous of the posterior
sura A ''surah'' (; ar, سورة, sūrah, , ), is the equivalent of "chapter" in the Qur'an. There are 114 ''surahs'' in the Quran, each divided into '' ayats'' (verses). The chapters or ''surahs'' are of unequal length; the shortest surah ('' Al-K ...
. Later, meta-analysis and follow on large sample cadaveric confirmation study make reference to the sural communicating branch and both reference this nerve complex as the components contributing to the formation of the sural nerve. In ''Steele et al.'' study identifying eight variations of the sural nerve formation
Types 1 and 7 sural nerve complex
formations possess a sural communicating branch. This recent cadaveric study a 50.79% prevalence of nerves with a sural communicating nerve. Ramakrishnan et al found that type 1 nerves (only sural nerve complex types that contain SCN as defined by his figures) were globally present in 51.50% of all cadaveric studies captured in their systematic review.


Additional images

File:RobertSteele SuralNerve GraysMODified.png , Most common formation (type 1) of the sural nerve depicted in the popliteal fossa File:sural nerve formation.jpg , Most common formation of the sural nerve by Steele et al. File:Type 1-8 SN formation.jpg, 8 documented types of sural nerve formation File:Gray826and831.PNG, Areas of skin sensation supplied by nerves in the leg. File:Gray834.svg, Areas of skin supplied by nerves of the leg - the sural nerve supplies the lateral ankle. File:Gray835.png, Deep nerves of the front of the leg. File:Gray836.png, Course of nerves at the bottom of the foot.


References


External links

Referenced papers:
Steele et al. 208 sample cadaveric review 2021

Ramakrishnan et al.systematic review on sural nerve formation 2015


Anatomy web references

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{{Authority control Nerves of the lower limb and lower torso