Anatomical variations of the sural nerve in the leg: A fetal study

Shankar, Nachiket; Selvam, Robert Patrick; Dhanpal, Nikhil; Ravikanth, Reddy; Alapati, Ashok

doi:10.4103/0028-3886.60390

Cited by 14 publications

(5 citation statements)

References 17 publications

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“…This could be probably due to the small sample size and study group was from Indian population. Similar results were observed in a fetal study on anatomical variations of sural nerve by Shankar N et al, [18]. However, results of the Mahakkanukrauh P et al, on In study done by Huelke et al, out of 3 Types of sural nerve, in Type A the site of union of the MSCN and the PCN was extremely variable [17].…”

Section: Other Findings Of Sural Nervesupporting

confidence: 65%

“…Shanker N et al, had found that the site of union was more in lower 2/3 rd of the leg (95%) and 5% in upper 1/3 rd of leg. In males the commonest site of union was the middle thirds, while in females it was the lower one thirds of the leg [18]. In present study, formation of sural nerve was more in lower 3 rd of leg in both males and females and in middle 3 rd the incidence of formation of sural nerve was more in males.…”

Section: Other Findings Of Sural Nervesupporting

confidence: 54%

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Anatomical Variations in Formation of Sural Nerve in Adult Indian Cadavers

A.N.¹

2013

JCDR

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Background: Sural nerve is formed by communication of medial sural cutaneous nerve, that arise from tibial nerve in popliteal fossa and peroneal communicating nerve, a branch directly from common peroneal nerve or from lateral sural cutaneous nerve. The sural nerve is universally recognized by surgeons as a site for harvesting an autologous nerve graft and for nerve biopsies in case of neuropathies. Setting and Design:Anatomy department and an observational study. Statistical Analysis:The Mean, Standard Deviation, relevant percentages and p value was calculated by Chi-square test. Material and Methods:The study consists of 50 lower limb specimens in 25 cadavers. All the male and female complete cadavers were included in the study. The data was collected by dissection method by using dissection instruments and parameters (measurements) were obtained by using measuring tape. Results:The sural nerve complex was dissected and observed in 50 formalin fixed lower limb specimens. Study was done in 16 male and 9 female cadavers. Three types of formation of sural nerve were observed were -Type A was seen in 36 specimens (72%) of cases. Type B was seen in 14 specimens (28%) of cases. Type C sural nerve was not found in present study. Site of union of components of SN was seen in the upper 3 rd of leg in 5.6%, in middle 3 rd it was in 33.3% and in lower 3 rd it was in 58.3% of cases. The length of the sural nerve shows a wide range from 2 cm to 32 cm. The symmetrical distribution was seen in 62.5% in males and 55.6% in female.

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Section: Other Findings Of Sural Nervesupporting

confidence: 65%

Section: Other Findings Of Sural Nervesupporting

confidence: 54%

Anatomical Variations in Formation of Sural Nerve in Adult Indian Cadavers

A.N.¹

2013

JCDR

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“…The possibility of missing these nerves cannot be ruled out. Moreover, according to previous studies, type 3 SN was identified only in few cases if not found at all [11]. For example, Pyun and Kwon [5] have verified the variation of SN formation through cadaver study and found 20 out of 26 legs of type 1, 4 cases of type 2, and 2 cases of type 4.…”

Section: Discussionmentioning

confidence: 96%

Could Ultrasound-Guided Stimulation of Sural Nerve Affect Nerve Conduction Study?

et al. 2019

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ObjectiveTo determine anatomical variation of the sural nerve (SN) by ultrasonography (US) and compare sensory nerve action potential (SNAP) of the SN obtained by a control method to that obtained with adjusted method using US.MethodsEighty legs of 40 healthy volunteers were enrolled. The location and formation of SN were investigated through US. Two methods of nerve conduction study (NCS) were then performed. In the control method, the cathode was placed 14 cm proximal to the lateral malleolus and the greatest SNAP amplitude was obtained by moving the cathode medially or laterally from just lateral to the calf-mid line. In adjusted NCS, the exact SN union site was stimulated in type 1. In other SN types, the stimulation was done directly over the nerve and the distance from the lateral malleolus was set to be 14 cm.ResultsIt was found that 73.8% of the SNs were type 1, 22.5% were direct continuation of MSCN (type 2), and 3.8% were MSCN and LSCN without communicating (type 4). However, type 3 was not found. The union point in type 1 SN was 12.6±2.5 cm proximal to the lateral malleolus and 1.4±0.7 cm lateral to the calf-midline. After stimulation adjustment, SNAP amplitude in type 1 SN was significantly increased (20.7±5.5 μV vs. 27.1±6.7 μV).ConclusionAnatomical variation of SN and its location were verified by US. US provides additional information for conducting sural NCS and helps obtain more accurate results.

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“…2). However, there are some anatomical variants of the SN [6], [7]. The classic pattern of sural nerve formation is the union of the medial sural cutaneous nerve (MSCN) and the lateral sural cutaneous nerve (LSCN).…”

Section: Methodsmentioning

confidence: 99%

Preliminary Evaluation of the Sural Nerve Using 22-MHz Ultrasound: A New Approach for Evaluation of Diabetic Cutaneous Neuropathy

et al. 2012

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BackgroundThe application of 22-MHz high-frequency ultrasound allows for visualization of the inner part of the sural nerve. The aim of this study was to evaluate the morphological changes of sural nerves in patients with type 2 diabetes mellitus using ultrasound.Materials and MethodsThe thickness/width (T/W) ratio, the cross-sectional area (CSA) of the sural nerves and the maximum thickness (MT) of the nerve fascicles were measured in 100 patients with type 2 diabetes mellitus and 50 healthy volunteers using 22-MHz ultrasound. Receiver operating characteristic (ROC) curves were plotted to determine the optimal cut-off values as well as the sensitivities and specificities. All parameters were significantly different between the subject and control groups. The ROC curves demonstrated that the MT was the most predictive of diabetic cutaneous neuropathy, with an optimal cut-off value of 0.365 mm that yielded a sensitivity of 90.3% and a specificity of 87.7%.ConclusionsThe results of this study suggest that 22-MHz ultrasound may be a valuable tool for evaluating diabetic cutaneous nerve neuropathy.

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Anatomical variations of the sural nerve in the leg: A fetal study

Abstract: The present study showed differences in the anatomy of the SN compared to earlier studies, warranting further studies in the Indian population.

Cited by 14 publications

References 17 publications

Anatomical Variations in Formation of Sural Nerve in Adult Indian Cadavers

Anatomical Variations in Formation of Sural Nerve in Adult Indian Cadavers

Could Ultrasound-Guided Stimulation of Sural Nerve Affect Nerve Conduction Study?

Preliminary Evaluation of the Sural Nerve Using 22-MHz Ultrasound: A New Approach for Evaluation of Diabetic Cutaneous Neuropathy

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