Sural Nerve Block
Regional Anesthesia and Chronic Pain Applications
Anatomy
The sciatic nerve splits into the tibial nerve and the common peroneal (fibular) nerve near the popliteal crease.
The tibial nerve travels distally, giving rise to the medial sural nerve and posterior tibial nerve, which cover the posterior leg and plantar surface of the foot.
The medial sural nerve runs between the gastrocnemius muscle heads, through the deep fascia to become superficial about halfway down the calf, and continues posterior to the lateral malleolus and superficial to the extensor retinaculum.
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The sural nerve block provides postoperative pain relief and regional anesthesia to the posterolateral calf and dorsolateral fifth digit.
While the sural nerve innervates the posterolateral calf and dorsolateral foot, it is the least studied of the five major ankle nerves. A PubMed search using the keywords "sural nerve" and "regional anesthesia" generated only six references.
This observation could be due to the omission of the sural nerve block in certain foot surgeries, as it only contributes a minor amount to the forefoot.
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