The posterior tibial nerve is a distal branch of the sciatic nerve.  Blocking it above the medial maleolus in the distal leg results in excellent anesthesia for the skin of the sole of the foot and the underlying deep structures.  This makes it a very useful block for deep wound exploration in the foot.  Additionally, the innervation of the calcaneous derives from the tibial nerve and this can be a nice selective block for patients with calcaneal fractures.  The ankle joint itself has multiple innervations and WILL NOT BE BLOCKED with a posterior tibial block alone.

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