Cutaneous innervation of the medial ankle: an anatomic study of the saphenous, sural, and tibial nerves and their clinical significance.

Abstract

The distribution and variability of the nerves innervating the skin overlying the medial ankle were determined in 22 human anatomic specimens using x3.5 loupe magnification for dissection. Five different types could be identified: (1) Type A received contributions from the saphenous (SP), sural (SR), and the tibial (TB) nerves (54%); (2) Type B received contributions from the SR and SP nerves (14%); (3) Type C received contributions from the TB and SP nerves (9%); (4) Type D was singularly innervated by the SP (14%); and (5) Type E received contributions only from the TB nerve (9%). In two specimens, an unusual connection between the SP and the medial plantar nerves was found. Based on these findings, an incision line for tarsal tunnel release is suggested to avoid injury to the small cutaneous branches of the SP, SR, and TB nerves.