A healthy 27-year-old female undergoing ankle debridement requires an ankle block. Which nerves must be adequately blocked?

A healthy 27-year-old female undergoing ankle debridement requires an ankle block. Which nerves must be adequately blocked?

• A. Deep peroneal, posterior tibial, saphenous, sural
• B. Deep peroneal, saphenous, superficial peroneal, sural
• C. Deep peroneal, posterior tibial, superficial peroneal, sural
• D. Deep peroneal, posterior tibial, saphenous, superficial peroneal

Answer: (D)

An ankle block aims to numb all the nerves that provide sensation to the ankle and most of the foot. Blocking the deep peroneal nerve stops sensation in the first web space between the big toe and second toe; blocking the superficial peroneal nerve covers most of the dorsum of the foot; blocking the saphenous nerve anesthetizes the medial malleolus and medial aspect of the foot; and blocking the posterior tibial nerve covers the plantar surface and the posterior ankle. Together, these four nerves give comprehensive anesthesia for ankle debridement. The sural nerve, which supplies the lateral hindfoot and heel, is not essential for a standard ankle procedure, so it’s not required here.

An ankle block aims to numb all the nerves that provide sensation to the ankle and most of the foot. Blocking the deep peroneal nerve stops sensation in the first web space between the big toe and second toe; blocking the superficial peroneal nerve covers most of the dorsum of the foot; blocking the saphenous nerve anesthetizes the medial malleolus and medial aspect of the foot; and blocking the posterior tibial nerve covers the plantar surface and the posterior ankle. Together, these four nerves give comprehensive anesthesia for ankle debridement. The sural nerve, which supplies the lateral hindfoot and heel, is not essential for a standard ankle procedure, so it’s not required here.