Where To Give Nerve Block For Ankle Surgery?


Feb 29, 2016

I recently had surgery on my ankle for a fractured fibula and torn ligament. Prior to surgery, my surgeon told me that he would have another doctor (pain doctor) administer a nerve block once I was under general anesthesia. The pain doctor met with me prior to the operation and advised that the nerve block would last anywhere from 15-24 hours. Unfortunately, the nerve block did not work correctly at all and I was in immense pain for a few hours post-op until I was given strong pain meds. I questioned my surgeon (because the pain doctor left after administering the nerve block) who said the nerve block must have worn off by the time the surgery ended (a couple hours tops), but from what I've researched it's not possible. Plus, I began to notice that the middle of my thigh was completely numb in the middle of the night. This numbness lasted approximately 24 hours.

My question is: Where should the pain doctor have administered the nerve block. I woke up with a bandaid in the area of my groin and was told this is where the nerve block was given (under ultrasound). However, I've read that for an ankle procedure, the block should have been given just above the knee to be effective. Does anyone have any knowledge on this subject?

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I'm a 38 year old with ankle and foot problems all my life. I was born with flat feet and I was always spraining my ankles. I acquired PTTD/Flat Foot on my left about a year ago and finally was diagnosed by an orthopedic foot and ankle expert. He recommended surgery and after a second opinion I decided I might as well get this taken care of so that I can go back to a normal life of walking through the streets of Europe.

I had my surgery about 2.5 weeks ago and I wanted to lend advice to those about to take on this crazy surgery. Firstly, the morning of surgery when the anesthesiologist was performing the nerve block it hurt like hell and made me even more panicked about the surgery. The relaxing medication they gave me did nothing to settle my nerves. I woke up from surgery a few hours later and I could feel all sorts of shocking pains coming from my foot. I asked if I should be feeling all the pain and they said that the nerve block failed. The anesthesiologist was busy for another hour and so I writhed in pain (crying hysterically) for the hour and vomited multiple times due to the extra anesthetic they gave me due to the failed nerve block.

Once the new anesthesiologist came she figured out that my nerve split into two and the other guy had not seen this split. After she was finished it was completely numb and I was worn out. I was sent home. Over the next day I vomited profusely, found out that I cannot breath when I take Oxycontin, I lost balance and fell on my foot and I was taking anything I could get my hands on for constipation. I finally found the foul tasting milk of magnesia and I can now go to the bathroom every few days.

My pain was managed by a morphine twice a day while in the splint, but now that I am in the cast my heel is killing me especially at night and the dr gave me hydrocodone which didn't touch the pain last night. Is it normal to have more pain at this point?

When will I be fairly pain free and when will I be able to leave the house? I live in Santa Barbara and i have an ocean view so I should not be complaining but i am feeling pretty horrid and ready to get out. When I think about leaving I worry about falling again and having my throbbing leg down.

Am I alone in all of this? Many experiences I have been reading say that after 5 days everything was hunky dory.

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I did notice that when I pressed on certain areas of the foot, I would feel a sharp pain. This occurred in the heel (from the bottom), toes (again, from the bottom, primarily the foot pad below the pinky, second, and 4th toes). When I asked the doctor about this, he said (around week 5) that it was just because I hadn't been using the foot.

The problem persisted, and this week, week 7, I was cleared to start partial weight-bearing--walking in the boot while taking approximately 1/2 the weight off my foot via the crutches. I don't have ankle pain to speak of (or at least, not often and only if I overdo it), but I have terrible shooting pains in my heel and toes as I step. It's OK if I take most of the weight on the crutches, but as soon as I go to more than just a little weight on the boot, the pain starts.

This week I also started PT and the therapist told me this is nerve pain--not uncommon after surgery (don't know why the doctor couldn't have told me this, but OK). I couldn't get much of an idea from her how long this will persist or if there is anything I can do about it.

I'm doing my ankle and leg exercises (those are mostly non-weightbearing at this point) and they are going great. The ankle is clearly healing well. But I don't see how I can progress to full weight bearing (supposed to try that next week!) when much more than a little pressure on the foot results in this nerve pain!

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(note this was right after the injury, pre-crutches, when there was still a lot of edema)

I'm now one month removed from a 6 week NWB stint on crutches for a 1.2cm OLT on my right ankle. I've been doing PT, yoga and general strengthening for about a month. I can jog with minimal pain and can walk/bike without any pain, but I cannot play the more intense sports I love like basketball, flag football etc.

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I was in a surgical shoe for four weeks, then tennis shoes for two weeks, then I could transition into other shoes. Recovery was pretty painful. I kept my foot elevated and iced it for the first week. I only walked when I had to use the restroom, and for the first few days that was almost impossible. It hurt so bad I ended up hopping to the bathroom on my other foot. So I got that surgery done in November and now it is March and my foot is doing great. Sometimes there is still slight pain in the second toe, it's still healing. My toes aren't 100% back to normal yet but I think they are close. I can walk/run on them with no problem.

I just had the same exact surgery on my left foot on February 28, 2014. This time I requested crutches since it was unbearable to walk on my foot the first time. I went home with crutches and used them for the first 4 days. Then on the 5th day I started to try to put pressure on my foot and begin to walk on it without the crutches. I thought the pain was getting better but it is now day 8 and I am in a lot of pain. My foot feels very hot, there is a burning sensation, and there are some stabbing pains. Usually the pain meds (Vicodin) help a lot with the pain. But tonight after taking one and seeing no improvement I took another, and still my foot is hurting very badly and I don't know what to do. Today is Friday and on Monday I have to go back to school so I'm trying to walk more and more everyday to prepare myself for having to walk around campus. I've already gone through this surgery before so I knew what to expect but so far the recovery for this foot has been slightly different from the first.
The pain is keeping me awake so I'm hoping it will ease off soon.

I would love to hear anyone's post-hammertoe surgery stories. Similarities or differences between our surgeries.

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