Both components of the sciatic nerve, common peroneal (CP) and tibial (T) nerves diverge from each other at the popliteal fossa. Lateral and medial gastrocne- mius muscles (GN) are also shown.
The sural nerve is shown behind the lateral malleolus.
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- Saphenous n
- Blocks postero-medial part of dorsum of foot
- Superficial infiltration around long saphenous vein anterosuperior to medial malleolus
- Tibial n
- Needle entry medial to Achilles tendon or lateral to posterior tibial artery at upper border of medial malleolus
- Determine depth with paraesthesia, nerve stimulator or 1 cm superficial to tibia
- Alternatively infiltration either side of artery behind medial malleolus
- Blocks sole, plantar surface of digits
- Deep peroneal n
- Needle entry between extensor hallucis longus and tibialis anterior tendons or lateral to anterior tibial artery
- Blocks first web space and short toe extensors
- Superficial peroneal n
- Superficial infiltration from lateral border of tibia to upper part of lateral malleolus
- Blocks dorsum of foot and toes except first web space
- Sural n
- Superficial infiltration from Achilles tendon to lateral malleolus
- Blocks lateral side of foot and fifth digit
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