Ankle Block for Hallux Valgus Repair

Evidence-Based Recommendation

• The American Society of Anesthesiologists recommends using ankle block as part of a multimodal analgesic approach for hallux valgus repair surgery, which provides effective postoperative pain relief and allows early mobilization, and should be performed with ultrasound guidance when possible to increase accuracy and reduce the risk of local anesthetic systemic toxicity 1

Technique Details

• When performing an ankle block for hallux valgus repair, consider using lower concentrations of local anesthetics without adjuncts to avoid dense blocks that might delay diagnosis of compartment syndrome 2

Clinical Considerations and Cautions

• Avoid dense, long-duration blocks that might mask compartment syndrome symptoms, and calculate safe doses of local anesthetics to prevent systemic toxicity 2
• Consider patient comorbidities and anticoagulation status when selecting regional techniques 3

Monitoring and Follow-up

• Assess block success thoroughly before proceeding with surgery to minimize the need for conversion to general anesthesia, and monitor for respiratory function, especially if the block is combined with sedation 1