title: Complications After Popliteal Block for Foot and Ankle Surgery.
abstract: BACKGROUND
  A popliteal nerve block is a common analgesic procedure for patients undergoing surgery on their knee, foot, or ankle. This procedure carries less risk in a surgical setting compared with other forms of anesthesia such as a spinal block. Previous reports demonstrated few to no complications with the use of this nerve block, but it is unclear whether these data are consistent with the recent increase in use of this analgesic procedure for lower extremity surgery.
  
  
  METHODS
  Retrospectively, a busy orthopedic foot and ankle practice performed a chart review examining for postoperative neuropathic complications possibly related to the popliteal nerve block. The 1014 patients who had undergone a popliteal block for foot and/or ankle orthopedic surgery were analyzed for short and long-term neuropathic complications. The collected data consisted of tourniquet time, pressure, and location as well as the method of finding the fossa nerve, adjuncts used, and patient medical history. Data were analyzed using chi-square, Fisher's exact, and t tests for analysis with a significance value of P < .05.
  
  
  RESULTS
  Of these 1014 patients, 52 patients (5%) developed deleterious symptoms likely resulting from their popliteal block, and 7 (0.7%) of these were unresolved after their last follow-up. No immediately apparent underlying causes were determined for these complications.
  
  
  CONCLUSIONS
  The frequency of a neuropathic complication following a popliteal nerve block was notably higher in the early postoperative period than indicated in the past. The proportion of patients with unresolved neuropathic symptoms at last follow-up is comparable to that previously reported in the literature.
  
  
  METHODS
  Level IV, retrospective case series.
authors.affiliation: Orthopaedic Associates of Michigan, Grand Rapids, MI, USA John.Anderson@oamichigan.com.
authors.forename: John G
authors.initials: JG
authors.lastname: Anderson
authors.affiliation: Orthopaedic Associates of Michigan, Grand Rapids, MI, USA.
authors.forename: Donald R
authors.initials: DR
authors.lastname: Bohay
authors.affiliation: Orthopaedic Associates of Michigan, Grand Rapids, MI, USA.
authors.forename: John D
authors.initials: JD
authors.lastname: Maskill
authors.affiliation: GRMEP/MSU Orthopaedic Residency, Grand Rapids, MI, USA.
authors.forename: Kuldeep P
authors.initials: KP
authors.lastname: Gadkari
authors.affiliation: Orthopaedic Associates of Michigan, Grand Rapids, MI, USA.
authors.forename: Thomas M
authors.initials: TM
authors.lastname: Hearty
authors.affiliation: GRMEP/MSU Orthopaedic Residency, Grand Rapids, MI, USA.
authors.forename: William
authors.initials: W
authors.lastname: Braaksma
authors.affiliation: Orthopaedic Associates of Michigan, Grand Rapids, MI, USA.
authors.forename: Michelle A
authors.initials: MA
authors.lastname: Padley
authors.affiliation: Van Andel Institute, Grand Rapids, MI, USA.
authors.forename: Kevin T
authors.initials: KT
authors.lastname: Weaver
mesh_terms: D000328:Adult; D000842:Ankle / Q000503:physiopathology / Q000601:surgery*; D015331:Cohort Studies; D016208:Databases, Factual; D005260:Female; D005500:Follow-Up Studies; D005528:Foot / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009407:Nerve Block / Q000009:adverse effects* / Q000379:methods; D019637:Orthopedic Procedures / Q000379:methods; D010147:Pain Measurement; D010149:Postoperative Pain / Q000503:physiopathology*; D010543:Peroneal Nerve; D020427:Peroneal Neuropathies / Q000453:epidemiology* / Q000209:etiology; D011183:Postoperative Complications / Q000453:epidemiology / Q000503:physiopathology; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome
keywords: arthritis; foot and ankle surgery; popliteal block; statistical analysis