Ankle block : Nerves and Landmarks

foot nerve supply

Mnemonic: The 3 nerves starting with letter “S” are sensory only and supply superior and side aspect of foot (dorsum).

1. Superficial peroneal nerve (L4-S1): located lateral to Extensor Digitorum Longus (EDL)

  • Supplies: dorsum of foot and toes except between the great and 2nd toe

2. Sural nerve (S1-S2): It is formed from the medial sural nerve (branch of the tibial nerve) and the lateral sural nerve (branch of the common peroneal nerve)

  • Location: superficially between lateral malleolus and achilles tendon
  • Supplies: posterolateral leg, lateral foot, 5th toe

3. Saphenous nerve (L3-L4): It is a branch of femoral nerve.

  • Location: just anterior to the medial malleolus
  • Supplies: anteromedial side of leg, medial side of foot

Other nerves (Motor + Sensory):

4. Deep peroneal nerve (L4-L5): located lateral to Extensor Hallucis Longus (EHL)

  • Sensory: between the great and second toes
  • Motor: extends the toes

5. Tibial nerve: It divides into lateral and medial plantar nerves just inferior to the medial malleolus.

  • Location: posterior to medial malleolus
  • Sensory: plantar surface of the foot
  • Motor: flexes the toes

Landmarks for Ankle block

  • Deep peroneal: Lateral to Extensor hallucis longus tendon
  • Posterior tibial: Posterior to posterior tibial artery
  • Sural: Posterior to lateral malleolus
  • Superficial peroneal: Lateral to ext. digitorum longus
  • Saphenous: Anterior to medial malleolus

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