Which structure is most commonly affected by a gastrocnemius recession?

Which structure is most commonly affected by a gastrocnemius recession?

• A. Tibial nerve
• B. Sural nerve
• C. Common peroneal nerve
• D. Saphenous nerve

Answer: (B)

During a gastrocnemius recession, the surgical field is in the posterior aspect of the proximal to mid-calf. The sural nerve travels along the posterolateral leg, often crossing near the gastrocnemius–soleus junction and then continuing toward the Achilles region with the small saphenous vein. This position puts the sural nerve in the path of incisions and dissection used to lengthen the gastrocnemius, making it the structure most at risk for injury. Damage would typically cause sensory loss or paresthesias over the lateral aspects of the foot and heel. The other nerves are less likely to be affected in this specific procedure: the tibial nerve lies deeper in the posterior compartment and is less exposed by the typical recession approach; the common peroneal nerve travels around the fibular neck and is not ordinarily encountered in a standard posterior calf recession; the saphenous nerve runs medially along the leg and is not in the posterior field of this operation. Hence, the sural nerve is the structure most commonly affected.

During a gastrocnemius recession, the surgical field is in the posterior aspect of the proximal to mid-calf. The sural nerve travels along the posterolateral leg, often crossing near the gastrocnemius–soleus junction and then continuing toward the Achilles region with the small saphenous vein. This position puts the sural nerve in the path of incisions and dissection used to lengthen the gastrocnemius, making it the structure most at risk for injury. Damage would typically cause sensory loss or paresthesias over the lateral aspects of the foot and heel.

The other nerves are less likely to be affected in this specific procedure: the tibial nerve lies deeper in the posterior compartment and is less exposed by the typical recession approach; the common peroneal nerve travels around the fibular neck and is not ordinarily encountered in a standard posterior calf recession; the saphenous nerve runs medially along the leg and is not in the posterior field of this operation. Hence, the sural nerve is the structure most commonly affected.