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Medial Sural Cutaneous Nerve

nervus cutaneus surae medialis

The medial sural cutaneous nerve is a branch of the tibial nerve arising in the popliteal fossa that descends along the posterior calf between the two heads of gastrocnemius. It joins the lateral sural cutaneous nerve (from the common peroneal via the peroneal communicating branch) to form the sural nerve typically at the mid-calf level. It supplies the skin of the posterior and medial calf before joining the sural nerve.

Region: Lower Leg

Clinical Relevance

Clinical Notes

The medial sural cutaneous nerve contributes the larger component to the sural nerve in most individuals. Its course along the small saphenous vein in the posterior calf is used as a landmark for saphenous vein stripping procedures. Injury of the medial sural cutaneous nerve during small saphenous vein harvesting produces medial calf and posterior ankle numbness. During sural nerve harvest, the entire sural nerve formed from both components can be harvested from the lateral malleolus to the mid-calf junction.

Pathology

Common Injuries & Conditions

Medial Sural Cutaneous Nerve Injury in Saphenous Vein Harvest

The small saphenous vein harvest for cardiac or peripheral bypass surgery travels alongside the medial sural cutaneous nerve in the posterior calf, and inadvertent nerve division produces persistent medial calf and posterior ankle numbness that may progress to neuropathic pain.