LESSONS LEARNED: AN INTERACTIVE SESSION WITH THE AAEP PAST PRESIDENTS
Fig. 7. Contrast media in the afferent lymph channels.
Since the information obtained from the Interna-
tional Symposium on Navicular Disease, Dortmund, Germany, 1993, this procedure has evolved in the author’s hands. The number of cases in which the described procedure has been used during the 19- year time span of use is difficult to identify. How- ever, a recently adopted record systemg tabulated the number of PDN blocks performed by the author from February 2010 to February 2013 to be 179. With the use of this information, it could be extrap- olated that over the past 19 years, the author per- formed approximately 1000 PDN blocks.
4. Discussion
The procedure facilitates a consistent site for the administration of a local anesthetic agent to the medial and lateral palmar/plantar digital nerves. It is easily performed, and the results are highly predictable. With the described technique, in the majority of cases, the level of anesthesia, as deter- mined by the lack of response to pressure at the coronet band from a blunt instrument, will be from the middle sulcus area of the coronet band dorsally to one fourth to one third of the distance to the toe.
Fig. 8. Plantar digital nerve block performed with 3 mL of mepivicaine and 3 mL of iodinated contrast media to evaluate migration of diluted media. Radiographs were taken within 5 minutes.
