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

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conducted a cadaveric study in which the posterior leg was exposed. She was studying the

nerve fascicle A nerve fascicle, is a bundle of nerve fibers belonging to a nerve in the peripheral nervous system. A nerve fascicle is also called a fasciculus. A nerve fascicle is enclosed by perineurium, a layer of fascial connective tissue. Each enclosed ...

contribution of each of the nerves that contribute to the final formation of 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 ...

to find better nerve donors. She originated the term sural nerve complex to fully encompass all contributions to the terminally named

(and later

lateral dorsal cutaneous nerve The lateral dorsal cutaneous nerve is a cutaneous branch of the foot. This nerve is the terminal nerve portion of the sural nerve. The common convention for where the sural nerve transitions into the ''lateral dorsal cutaneous nerve'' is after th ...

). Further research would go on to use the sural nerve complex terminology to discuss the

lateral sural cutaneous nerve The lateral sural cutaneous nerve of the lumbosacral plexus supplies the skin on the posterior and lateral surfaces of the leg. The lateral sural cutaneous nerve originates from the common fibular nerve''(L4-S2)'' and is the terminal branch of t ...

, the

medial sural cutaneous nerve The medial sural cutaneous nerve ''(L4-S3)'' is a sensory nerve of the leg. It supplies cutaneous innervation the posteromedial leg. Structure The medial sural cutaneous nerve originates from the posterior aspect of the tibial nerve of the sc ...

, the sural communicating nerve and

proper.

Morphology

Recent cadaveric research shows that there are potentially ''six to eight variations'' of the sural nerve complex. Ramakrishnan et al. reviewed 39 cadaveric studies (limbs n= 3974) and concluded that there were 6 common classifications of the contributing nerves in the origins of the sural nerve. Later cadaveric research in which 208 limbs were dissected demonstrated two variations that were unaccounted for and directly align with what previous sural nerve anatomists had uncovered in both case reports and direct research. These two variations (type 7 and 8 according to Steele et al.) demonstrate a parallel course for the medial sural cutaneous nerve and the sural nerve. Most common formations ar
type 1 and 3
according to Ramakrishnan et al., Steele et al. found the same prevalence of sural nerve complex formation. The following imag
is of type 1-8 sural nerve formation
and is a replica of what both Ramakrishan and Steele found in their work. Ramakrishnan successfully defined
types 1-6
with the largest difference being the addition o
type 7 and 8
sural nerve complex by Steele. These two formations were robustly vetted due to their prevalence in the sample (in a high power study) that directly correlates with both historical and previous case literature describing formations of these SNC types.

Contributing Nerves

Lateral sural cutaneous nerve The lateral sural cutaneous nerve of the lumbosacral plexus supplies the skin on the posterior and lateral surfaces of the leg. The lateral sural cutaneous nerve originates from the common fibular nerve''(L4-S2)'' and is the terminal branch of t ...

Medial sural cutaneous nerve The medial sural cutaneous nerve ''(L4-S3)'' is a sensory nerve of the leg. It supplies cutaneous innervation the posteromedial leg. Structure The medial sural cutaneous nerve originates from the posterior aspect of the tibial nerve of the sc ...

* Sural communicating nerve

Additional images

File:Type 1-8 SN formation.jpg, 8 documented types of sural nerve formation, nerves are in order by type starting at top left and ending on bottom right. 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: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:
Ortigeula et al SNC originating paper

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