Grossly, the course of this nerve leads it from its highly varied anastomotic formation[3] to its more predictable terminal course down the remaining posterior leg.

The anastomosis forming the sural nerve typically occurs in the deep fascia above or within the surrounding space above the gastrocnemius muscle.

The formation patterns of the sural nerve complex is much more complicated and highly varied as documented by anatomists.

[8] The sural nerve has a purely sensory function, and so its removal results in only a relatively minor consequential deficit.

[9][10] It is frequently a site of iatrogenic nerve injury during percutaneous repair of the Achilles tendon or surgical interventions on the lower extremity.

In addition, the sural nerve will be involved in any kind of generalized peripheral sensory or sensorimotor neuropathy.

Also, due to its superficial properties, the sural nerve is easily blocked at multiple levels at or above the ankle.

[18] Sural nerve block is not advised if a patient is allergic to the anesthetic solution, has infected tissue at the injection site, has severe bleeding disorder, or has preexisting neurological damage.

[19] This article incorporates text in the public domain from page 963 of the 20th edition of Gray's Anatomy (1918) Referenced papers: