The saphenous nerve descends along the medial lower leg to cross the medial malleolus, supplying the skin of the medial ankle, medial heel, and medial arch. It is the terminal branch of the femoral nerve and the only branch of the femoral nerve to reach below the knee, providing cutaneous innervation without motor supply.
Saphenous nerve injury at the ankle is a complication of medial ankle surgery, great saphenous vein stripping, and ankle arthroscopy via the anteromedial portal. It presents as medial ankle numbness and burning pain. The saphenous nerve is deliberately blocked at the ankle for hallux and medial forefoot procedures. Ankle saphenous nerve entrapment in scar tissue after medial ankle procedures is treated by neurolysis.
Saphenous nerve compression in scar tissue at the medial malleolus after ankle surgery or vein stripping, producing medial ankle burning and numbness requiring neurolysis or perineural injection.
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