An unusual origin and intramuscular course of the sural nerve – a case report

The sural nerve is usually formed by the medial sural cutaneous nerve and peroneal communicating nerve,branches of the tibial nerve and the common peroneal nerve, respectively. During routine dissection of the left leg of an elderly male cadaver the sural nerve was seen to arise entirely from the common peroneal nerve. The sural nerve on this side was found to have an intramuscular course through the gastrocnemius. To our knowledge this is the first case report of the sural nerve arising entirely from the peroneal communicating nerve and also having an intramuscular course through the gastrocnemius. On the right side, it was observed that the sural nerve was formed in the popliteal fossa and had contributions from both the medial sural cutaneous nerve and the peroneal communicating nerve. The sural nerve is clinically important as it is commonly used for biopsies,nerve conduction studies and as a convenient source for nerve grafting. In all these procedures, the formation and course of the sural nerve in the calf assumes great significance.