Abstract

Background: Regional anesthesia is widely used in forefoot surgery, with ankle and popliteal sciatic blocks being the most common techniques. Studies suggest both provide effective analgesia but may differ in duration of pain relief, motor impairment, and implications for early mobilization and satisfaction.

Objective: To compare ultrasound-guided ankle block with ultrasound-guided single-shot popliteal block in forefoot surgery, focusing on postoperative pain control, complications, motor function, mobilization, and patient satisfaction.

Methods: A purposive PubMed search (1995–2025) identified peer-reviewed studies on hallux valgus, quintus varus, hallux rigidus, and hammertoe procedures. Findings were qualitatively synthesized.

Results: Popliteal blocks generally yield longer analgesia and reduce early opioid use but cause profound motor blockade and delayed ambulation. Ankle blocks offer adequate pain control, earlier mobilization, and high patient satisfaction, though they require multiple injections. Reported complication rates are low for both, but transient neurological events seem to appear more frequently with popliteal blocks. Data on quintus varus, hallux rigidus, and hammertoe surgery remain limited, though similar trends are observed. Combined ankle and popliteal blocks may enhance outcome in selected cases.

Conclusion: Both techniques are effective but reflect different trade-offs. Ankle blocks are preferable when early ambulation is desired, while popliteal blocks may be better for procedures with higher pain levels, such as hallux valgus or rigidus correction. Further high-quality trials are needed to establish best practice.