Popliteal Nerve Block and Toe Movement After Ankle Surgery: What You Need to Know

A popliteal nerve block anesthetizes the sciatic nerve’s tibial and common peroneal branches near the knee. It does not typically cause loss of toe movement because the muscles that extend the toes (extensor hallucis longus, extensor digitorum longus) are innervated by the deep peroneal nerve, a branch of the common peroneal nerve. However, the block often includes the common peroneal nerve, which can temporarily weaken ankle dorsiflexion and toe extension.

If a patient experiences complete inability to move the toes after ankle surgery, it suggests a peroneal nerve injury or isolated deep peroneal nerve block, not a standard popliteal block alone. Surgeons and anesthesiologists should be notified immediately to evaluate for nerve compression, hematoma, or direct trauma.