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Palmar/Plantar Digital Nerve Block Minimize

Prepare skin as discussed previously (perineural anesthesia)

  1. Elevate foot
  2. Palpate neurovascular bundles, abaxial to the flexor tendons.
  3. Insert needle on axial side of n-v bundle (25gx 5/8" needle). Point needle slightly abaxial and distal. Insert at the level of the collateral cartilages.
  4. Attach syringe to needle and inject 2-3mL mepivicaine per side.
  5. Wait 5-10 min check block by pinching skin with hemostats.

 


 

Structures Anesthetized

  • Navicular bone
  • Navicular bursa
  • Distal sesamoidean ligaments
  • Deep Digital Flexor tendon and sheath
  • Digital cushion
  • Corium of frog
  • Palmar 1/3-2/3 of sole
  • Palmar pastern and coffin joints
  • Palmar distal phalanx / wings of coffin bone
  • Palmar Skin

 


 

Common Conditions Diagnosed

  • Navicular Syndrome
  • Heel Pain Syndrome
  • Wing Fractures of P3
  • Subsolar abscess
  • +/-Pedal osteitis
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