Ankle Block

Ankle block is a useful regional anesthetic technique for foot surgery, especially in the ambulatory setting.¹ Additionally, ankle block provides excellent postoperative analgesia, which is important because foot surgeries often involve several osteotomies that cause moderate to severe postoperative pain, which is difficult to manage with standard oral analgesic regimens.

The foot is innervated by five nerves: four are terminal branches of the sciatic nerve, and one is the terminal branch of the femoral nerve. Many of the nerves of the foot can be directly imaged with ultrasound. This approach is more targeted than traditional ankle blocks. Using ultrasound guidance, it may be possible to improve patient comfort during the procedure and produce more complete blocks. In addition, more proximal blocks of the foot may be indicated when edema or infection is present. In contrast to blocks of the sciatic nerve in the popliteal fossa, ankle blocks do not produce foot drop, and therefore patient disposition is potentially facilitated.