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Metacarpal Nerve Block
Indications and Clinical Considerations
Metacarpal nerve block is used primarily in 2 clinical situations: (1) to provide surgical anesthesia in the distribution of the digital nerves for laceration, tendon, and fracture repair and (2) to provide postoperative pain relief after joint replacement or major surgical procedures on the hand ( Fig. 100.1 ).
Clinically Relevant Anatomy
The common digital nerves, which are also known as the metacarpal nerves, arise from fibers of the median and ulnar nerves. The thumb also has contributions from superficial branches of the radial nerve. The common digital nerves pass along the metacarpal bones and divide as they reach the distal palm ( Fig. 100.2 ). The volar digital nerves supply the majority of sensory innervation to the fingers and run along the ventrolateral aspect of the finger beside the digital vein and artery. The smaller dorsal digital nerves contain fibers from the ulnar and radial nerves and supply the dorsum of the fingers as far as the proximal joints.
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