Innervation Motor none Sensory posterolateral aspect of distal third of leg lateral aspect of foot, heel, and ankle Reflex none Origin CNS origin made of branches from the common peroneal nerve and tibial nerve nerve roots: L4-S4 Course Branch from the common peroneal nerve - lateral sural cutaneous before the its bifurcation into superficial and deep peroneal nerves, the common peroneal gives off a small cutaneous branch called lateral sural cutaneous Branch from the tibial nerve - medial sural cutaneous before diving behind the gastrocnemius, the tibial nerve gives off a small cutaneous branch called the medial sural cutaneous nerve courses laterally over the lateral head of the gastrocnemius Sural nerve formation at the distal third of the gastrocnemius, both sural cutaneous branches join to become the sural nerve descends on the posterolateral aspect of leg travels posterior to lateral malleolus and deep to fibularis tendon sheath Terminal branches lateral dorsal cutaneous nerve lateral calcaneal branches Injury & Clinical Conditions Sural nerve entrapment mechanism parts of pathway include a non-extensible fibrous arcade presentation chronic pain in posterior aspect of leg treatment neurolysis or other modalities to decrease frictional irritation Sural nerve biopsy indication estabilsh cause of peripheral neuropathies results helps confirm diagnosis distinguishes between different types of nerve damage identifies specific inflammatory diseases of the peripheral nerves Sural nerve graft frequently used as cable grafts blood supply to sural nerve graft posterior tibial artery - muscular branches peroneal artery - cutaneous branches up to 25 cm can be harvested indications facial reanimation segmental loss of a motor or sensory nerve with viable distal and proximal segments accessible for grafting Sural nerve block anesthesia to lateral foot