Sural nerve lesions: a report of 20 cases

Given the rarity of sural nerve mononeuropathy, this retrospective study reports 20 cases observed during the last 12 yr, with some cases having especially unusual mechanisms of the nerve lesion. Five of the 20 cases were considered S1 root disease until electrodiagnostic findings. In the 14 other cases, the nerve lesion was suspected because of concomitant trauma. This series is the largest sample of sural nerve lesions so far reported, and it underlines the importance of iatrogenic lesions, which account for 12 of the 20 cases. Some lesions are due to unusual conditions, such as small saphenous vein stripping and compression by the deep fascia. This series also demonstrates that even when lower limb trauma exists, some cases can be considered S1 root disease and that when the area of impaired sensation corresponds exactly to the cutaneous territory of a nerve trunk, one should first consider a truncular origin of the nerve lesion.