The sural nerve is a somatosensory nerve that provides sensation to the posterolateral aspect of the lower leg and the lateral part of the ankle and foot. Due to its location and anatomical properties, it is often used as an autologous nerve graft. However, the nerve harvest can be complicated by the presence of side branches. The objective of this study was to investigate the anatomy of the sural nerve and to map its side branches. This information can be used to predict the localization of separate incisions during the stair-step incisions technique for nerve harvest, thereby reducing the risk of complications. The study involved the dissection of 50 adult cadaveric legs (25 left and 25 right) obtained from 27 Central European cadavers. The focus of the dissection was to identify the sural nerve, small saphenous vein, and surrounding anatomical structures. Detailed measurements were taken on the side branches of the sural nerve, tributaries of the small saphenous vein, and their interrelationship. The average number of sural nerve side branches in a single leg was 4.2±1.9. These side branches were categorized into six groups based on their location and course: mediodistal, medioproximal, lateroproximal, laterodistal, medial perpendicular, and lateral perpendicular. Specific patterns of combination of these side branches were also identified and described. The branching point of the sural nerve was found to be 5.8±2.7 cm proximal to the lateral malleolus, whereas the small saphenous vein branching point was located more distally, 4.5 ± 2.8 cm proximal to the lateral malleolus. The highest density of sural nerve side branches was found 2.1–6.0 cm above the lateral malleolus. This study presents valuable data about the relationship between the sural nerve and the surrounding anatomical structures in the distal part of the leg, including the identification of its side branches and their relevance during nerve harvest procedures. On the basis of the most frequent locations of side branches, a three-incision-technique for nerve harvest is proposed.

中文翻译：

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远端腿腓肠神经的解剖学考虑：侧分支模式及其在神经采集过程中的意义

腓肠神经是一种体感神经，为小腿后外侧以及踝关节和足部的外侧部分提供感觉。由于其位置和解剖学特性，它经常被用作自体神经移植物。然而，神经采集可能因侧枝的存在而变得复杂。本研究的目的是研究腓肠神经的解剖结构并绘制其侧枝图。该信息可用于预测神经收获阶梯切口技术期间单独切口的定位，从而降低并发症的风险。该研究对从 27 具中欧尸体中获得的 50 具成人尸体腿（25 条左腿和 25 条右腿）进行了解剖。解剖的重点是识别腓肠神经、小隐静脉和周围的解剖结构。对腓肠神经的侧支、小隐静脉的支流及其相互关系进行了详细的测量。单腿平均腓肠神经侧支数为4.2±1.9。这些侧支根据其位置和走向分为六组：近中、近中、近侧、远远、内侧垂直和外侧垂直。还确定并描述了这些侧枝组合的具体模式。腓肠神经的分支点位于外踝近端 5.8±2.7 cm 处，而小隐静脉分支点位于更远端，距外踝近端 4.5 ± 2.8 cm 处。腓肠神经侧支密度最高出现在外踝上方 2.1~6.0 cm 处。这项研究提供了有关腓肠神经与腿部远端周围解剖结构之间关系的有价值的数据，包括其侧枝的识别及其在神经采集过程中的相关性。根据侧枝最常见的位置，提出了一种三切口神经采集技术。