The medial dorsal cutaneous nerve is the medial terminal branch of the superficial fibular (peroneal) nerve. It passes in front of the ankle and divides into a branch to the medial side of the big toe and a branch to the adjacent sides of the second and third toes. It supplies the skin of the medial dorsum of the foot.
| Origin | Superficial fibular nerve, which divides in the lower third of the leg after piercing the deep fascia |
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| Course | Passes over the front of the ankle superficial to the extensor retinaculum and divides on the dorsum of the foot into its digital branches |
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| Sensory |
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The branch running along the inner side of the big toe (dorsomedial hallux nerve) is at risk during bunion surgery and can be compressed by tight footwear, causing numbness or neuroma pain. The nerve can also be pressed by tight laces or boot tongues across the front of the ankle. The web space between the first and second toes is not supplied by this nerve but by the deep fibular nerve, which helps localise lesions.
Incisions over the first metatarsophalangeal joint can damage this branch, leaving numbness or a tender neuroma on the inner side of the big toe.
Tight laces or a stiff boot tongue compress the nerve over the front of the ankle and midfoot, causing tingling over the top of the foot that eases with looser lacing or padding.
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