First page Back Continue Last page Overview Graphics
digital nerve anatomy
for a unilateral wedge resection digital block may only be necessary on one side of toe
excessive volume should not be given as this constricts the circulation – compartment syndrome
adrenaline should never be used, as digital arteries are end arteries and its use may result in ischaemia
Notes:
The nerves supply to the toe comes from a digital nerve. This digital nerve, which is on the plantar surface, which branches pass dorsally. The nail bed and nail developmentally are plantar and dorsal structures and they migrate on to the dorsum of the toe making this area more difficult to anaesthetise and requiring a little extra time because of the distance. To gain complete anaesthesia these dorsal branches of the nerve can be anaesthetised with direct infiltration along the dorsum of the toe subcutaneously and an additional technique is to also after the local anaesthetic has worked – 95% to give a extra little injection into the nail bed can usually be tolerated well.