Background

Surgery around the ankle is increasingly embedded in outpatient treatment concepts. Unfortunately, the classic “ankle block” as a concept of regional anesthesia is inappropriate for surgery around the ankle because the injection sites are too distal to block this specific region.

Methods

The “high ankle block” avoids this disadvantage by dislocating the injection points 15 cm proximal to the malleoli. Three of five peripheral nerves necessary to perform the block can be reached by a circumferential subcutaneous wall. The Posterior Tibial Nerve and the Deep Peroneal Nerve are addressed by an ultrasound guided approach.

Results

The efficacy of the technique is highlighted by a case series (3 cases) in which the new blockade was used as a stand-alone procedure, i.e. without additional general anesthesia.

Conclusions

The “high ankle block” may serve as an ultrasound guided expansion to the classic techniques, extending the operative spectrum to the ankle region.

中文翻译：

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用于踝关节手术的“高脚踝阻滞”

背景

围绕脚踝的手术越来越多地融入门诊治疗理念。不幸的是，作为区域麻醉概念的经典“踝关节阻滞”不适用于踝关节周围的手术，因为注射部位太远而无法阻断该特定区域。

方法

“高脚踝阻滞”通过将注射点移至踝关节近端 15 厘米处避免了这一缺点。执行阻滞所需的五根外周神经中的三根可以通过环绕的皮下壁到达。胫后神经和腓深神经通过超声引导方法处理。

结果

一项病例系列（3 例）突出了该技术的功效，在该病例系列中，新的阻断剂被用作独立程序，即无需额外的全身麻醉。

结论

“高踝关节阻滞”可以作为超声引导下对经典技术的扩展，将手术范围扩展到踝关节区域。