Tibial Nerve Block Using an Ultrasound-Guided Inframalleolar Medial Plantar Nerve Perineural Injection: A Technical Note

J Clin Ultrasound. 2017 Mar 4;45(3):134-137. doi: 10.1002/jcu.22446. Epub 2017 Jan 25.


Sonographic-guided tibial nerve block allows for rapid anesthetization of the heel and plantar regions of the foot. We describe a variant technique for tibial nerve regional anesthesia utilizing perineural injection of the medial plantar nerve proximal to the sustentaculum tali where the nerve is superficial and readily accessed, with resultant retrograde flow of local anesthetic proximally. Perineural injection of the medial plantar nerve at the inframalleolar level provides a simple, safe, and effective alternative method to achieve tibial nerve block for regional anesthesia in a variety of procedures. © 2016 Wiley Periodicals, Inc. J Clin Ultrasound 45:134-137, 2017.

Keywords: anesthesia; foot; musculoskeletal system; perineural injection; tibial nerve; ultrasound guidance.

Publication types

  • Technical Report

MeSH terms

  • Adult
  • Anesthetics, Local / administration & dosage*
  • Bupivacaine / administration & dosage
  • Female
  • Humans
  • Lidocaine / administration & dosage
  • Male
  • Middle Aged
  • Nerve Block / methods*
  • Tibial Nerve / diagnostic imaging*
  • Tibial Nerve / drug effects*
  • Ultrasonography, Interventional*
  • Young Adult


  • Anesthetics, Local
  • Lidocaine
  • Bupivacaine