Transmuscular Course of the Medial Sural Cutaneous Nerve and its Clinical Implications

Variations of nerve are not only of anatomic and embryological interest but also of clinical importance. Their adequate knowledge will help in increasing surgical precision and decreasing morbidity. Anatomical variations in the formation of the sural nerve are common, although the topographical localization of this nerve is constant. In this report, we describe a case of an anomalous course of the medial sural cutaneous nerve which descended through the gastrocnemius via a tunnel formed within the muscle. Such anatomical variation of the sural nerve is clinically important when evaluating sensory axonal loss in distal axonal neuropathies since sural nerve mononeuropathy is less likely to occur.