Sural Nerve Grafting in Peripheral Nerve Repair: The Expanding Role of Ultrasonography

The sural nerve grafting plays a crucial role in the repair of peripheral nerve impairments when tension-free neurorrhaphy is unfeasible. The sural nerve is frequently utilized in sensory and mixed nerve repairs because of its anatomical reliability, sensory characteristics, and low donor site morbidity. This article critically reviews the current knowledge in the field and examines the anatomical and histological features of the sural nerve, along with contemporary harvesting techniques and clinical applications. High-resolution ultrasound (US) is highlighted as a non-invasive, real-time instrument for preoperative preparation, intraoperative mapping, and postoperative assessment. Ultrasonography enhances procedural precision, resulting in superior outcomes and less complications. Given the constraints of sural nerve grafts, alternative solutions such processed allografts and synthetic guidance are being evaluated.