The sural nerve enters the foot posterior to the lateral malleolus and passes inferior to the calcaneus, dividing into lateral dorsal cutaneous branches supplying the lateral foot and little toe and medial calcaneal branches supplying the heel. It is the primary sensory nerve of the lateral foot.
Sural nerve entrapment at the lateral ankle is a cause of lateral foot pain and little toe numbness after ankle sprain. The nerve is vulnerable to injury during peroneal tendon surgery, lateral ankle stabilisation procedures, and calcaneal osteotomy. It is the most common donor nerve for sural nerve grafting in peripheral nerve reconstruction surgery, with a well-defined territory and predictable anatomy.
Sural nerve compression at the lateral retromalleolar groove producing burning lateral foot pain and little toe numbness after ankle injury, treated by nerve decompression at the lateral malleolus.
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