BACKGROUND The distal saphenous nerve is commonly known to provide cutaneous innervation of the medial side of the ankle and distally to the base of the great toe. We hypothesize that the saphenous nerve innervates the periosteum of the medial malleolus and joint capsule. METHODS Five fresh limbs were dissected and the saphenous nerve was traced distally with magnification. The medial malleolus, talus, and soft tissue were fixed in formaldehyde, decalcified, and embedded in paraffin and sectioned. Histologic slides were then prepared using S100 antibody nerve stains. RESULTS Histologic slides were examined and myelinated nerves could be observed within the medial capsule and periosteum in all the specimens. CONCLUSIONS We have demonstrated that the saphenous nerve innervates the periosteum of the medial malleolus and joint capsule.