Prepare skin as discussed previously (perineural anesthesia)
- Elevate foot
- Palpate neurovascular bundles, abaxial to the flexor tendons.
- 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.
- Attach syringe to needle and inject 2-3mL mepivicaine per side.
- Wait 5-10 min check block by pinching skin with hemostats.
- 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