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#Ficb Reel by @pnbschool - The Pericapsular Nerve Group (PENG) block targets the articular branches of the femoral nerve, obturator nerve, and accessory obturator nerve along th
192.4K
PN
@pnbschool
The Pericapsular Nerve Group (PENG) block targets the articular branches of the femoral nerve, obturator nerve, and accessory obturator nerve along the superior pubic ramus — providing focused anterior hip capsule analgesia. High-yield uses: • Hip fractures • Total hip arthroplasty • Hip dislocation reduction • Severe preop hip pain limiting positioning Why it matters: • Opioid-sparing • Preserves quadriceps strength (when done correctly) • Improves positioning for spinal • Clean ultrasound landmarks Key technical point: Needle to the iliopubic eminence. Confirm spread deep to psoas tendon along the pubic ramus — not intramuscular. Pro tip: combine with the LFCN Block for total hip arthroplasty. Save this. Share with someone who still defaults to femoral for every hip. #RegionalAnesthesia #PENGblock #UltrasoundGuided #Anesthesia #HipFracture
#Ficb Reel by @pnbschool - The PENG block might be the most misunderstood block in regional anesthesia. Many clinicians expect it to fix all hip pain after total hip arthroplas
15.4K
PN
@pnbschool
The PENG block might be the most misunderstood block in regional anesthesia. Many clinicians expect it to fix all hip pain after total hip arthroplasty. That’s not what it’s designed to do. ⸻ What the PENG block actually does well • Targets the anterior hip capsule • Reduces early postoperative pain • Decreases opioid use in the first 24 hours • Improves early patient comfort This is why it fits well within ERAS pathways for hip replacement. ⸻ What it does NOT do ✖ Eliminate posterior hip pain ✖ Replace multimodal analgesia ✖ Consistently improve ambulation Hip pain after THA is multifactorial, and the PENG block only addresses one part of the problem. ⸻ Clinical takeaway The PENG block is an adjunct, not a standalone strategy. When combined with a Lateral Femoral Cutaneous Block, multimodal analgesia and optimized perioperative care, it can meaningfully improve early recovery. ⸻ Follow @PNBschool for regional anesthesia education used by 50,000+ anesthesia clinicians worldwide. ⸻ High-reach hashtags #regionalanesthesia #anesthesiology #nerveblocks #ultrasoundguided #hipreplacement
#Ficb Reel by @pnbschool - The femoral nerve block is a gold standard block - because of the motor block you just need to be selective when to use it. Two times I routinely use
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PN
@pnbschool
The femoral nerve block is a gold standard block — because of the motor block you just need to be selective when to use it. Two times I routinely use the femoral block: 1️⃣ ACL reconstruction A femoral nerve block combined with a popliteal sciatic block provides excellent anterior and posterior knee analgesia. These patients are usually non weight bearing for a day anyways. 2️⃣ Total knee arthroplasty (as a third block) When additional analgesia is needed, a femoral block can complement an adductor canal block + IPACK, particularly for persistent anterior knee pain. Regional anesthesia is rarely about one block — it’s about building the right combination along with multimodal analgesics for the best possible outcome. PNBschool — We make regional anesthesia easy. #regionalanesthesia #anesthesia #nerveblocks #aclreconstruction #anestezi
#Ficb Reel by @orthobulletsofficial - Here is a clip from our latest episode of CoinFlips & Controversies, "Open Pilon Fracture in 56M Hunter" featuring expert faculty from the FOT Pelvic
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@orthobulletsofficial
Here is a clip from our latest episode of CoinFlips & Controversies, “Open Pilon Fracture in 56M Hunter” featuring expert faculty from the FOT Pelvic Acetabular Course 2026 (taking place May 8, 2026 at FIVE Labs in Tampa, FL). Watch Drs. @krystinhidden & Kandemir, discuss “Balancing Soft-Tissue Preservation and Articular Accuracy in Complex Pilon ORIF." Click the Link in Bio to learn more about the 2026 FOT Pelvic Acetabular Course and watch their full webinar on Orthobullets.
#Ficb Reel by @pnbschool - LFCN Block - Level Determines Coverage. I promise no stimulation on incision! The lateral femoral cutaneous nerve is small, variable, and easy to mis
27.4K
PN
@pnbschool
LFCN Block — Level Determines Coverage. I promise no stimulation on incision! The lateral femoral cutaneous nerve is small, variable, and easy to miss. If you perform the block too distal, you often lose posterior-lateral thigh coverage. 📍 Target the nerve proximally near the ASIS as it exits through the inguinal ligament. Blocking at this level captures proximal branching and improves reliability of lateral and posterior-lateral sensory coverage. For hip surgery: 👉 Combine LFCN + PENG. • PENG → anterior capsule analgesia • LFCN → lateral thigh cutaneous coverage Integrated into a multimodal plan, this combination can significantly reduce perioperative opioid requirements. The hip is a large complex joint. These blocks are not 100% analgesic but after performing 5-600 of these combos I can tell you patients recognize how well these blocks work…..especially when they wear off. Regional anesthesia is anatomy-driven. Level matters. Save this for your next hip case. #regionalanesthesia #anesthesia #anestezi #anesthesiologist #crna Citations: Hadzic A, et al. Ultrasound-guided lateral femoral cutaneous nerve block: anatomical considerations and technique. Reg Anesth Pain Med. 2004;29(6):542-545. Girón-Arango L, et al. Pericapsular nerve group (PENG) block for hip fracture. Reg Anesth Pain Med. 2018;43(8):859-863.
#Ficb Reel by @the_ortho_minute (verified account) - Proton Pump Inhibitors associated with increased nonunion risk? JOT Large database study of over 410,000 operatively treated long-bone fractures. Po
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TH
@the_ortho_minute
Proton Pump Inhibitors associated with increased nonunion risk? JOT Large database study of over 410,000 operatively treated long-bone fractures. Postoperative proton pump inhibitor use was associated with higher nonunion rates in tibia/fibula and radius/ulna fractures. No clear signal in femur or humerus fractures. The association was strongest in younger patients, particularly ages 18–44. Groups were well matched, but this is observational data. Medication use is based on prescriptions, fracture details are limited, and causation cannot be inferred. #orthopedicsurgery #fracture #orthopedics #research
#Ficb Reel by @orthobulletsofficial - Here is a clip from our latest episode of CoinFlips & Controversies, "Vertical Shear Pelvic Ring Injury in 38M." Watch Drs. @kcvemu6 & Burns, discus
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@orthobulletsofficial
Here is a clip from our latest episode of CoinFlips & Controversies, “Vertical Shear Pelvic Ring Injury in 38M.” Watch Drs. @kcvemu6 & Burns, discuss “Protecting Vertical Instability and Managing Symphyseal Plate Failure After Pelvic Ring Fixation." Click the Link in Bio to learn more and watch their full webinar on Orthobullets.
#Ficb Reel by @relayluoli2026 - Surgical efficiency isn't about rushing; it's about reducing unnecessary steps. The screw-in PEEK-knotless anchor streamlines the workflow significant
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RE
@relayluoli2026
Surgical efficiency isn’t about rushing; it’s about reducing unnecessary steps. The screw-in PEEK-knotless anchor streamlines the workflow significantly. With no knots to tie and a self-punching tip that eliminates the need for a separate pilot hole in many cases, we cut down on instrument exchanges. That means less time with the shoulder distended and more focus on the quality of the repair. I’m using this for SLAP lesions where space is limited and every millimeter counts. The PEEK material offers the strength I need without the MRI artifact you get with metal. When you combine speed with reliability, the patient ultimately benefits from a shorter anesthetic time and a robust construct. #SLAPRepair #OrthopedicSurgery #SurgicalEfficiency #Arthroscopy #PEEK #sportsmedicine
#Ficb Reel by @surgixltd - A closer look at how a bipolar shell is assembled for a hip implant, an essential step in creating a stable and smoothly functioning joint replacement
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SU
@surgixltd
A closer look at how a bipolar shell is assembled for a hip implant, an essential step in creating a stable and smoothly functioning joint replacement.🦴🔧 #HipReplacement #Orthopaedics #JointHealth #SurgicalPrecision #SurgixJamaicaLtd
#Ficb Reel by @orthobulletsofficial - Here is a clip from our latest episode of CoinFlips & Controversies, "Periprosthetic Femur Fracture Nonunion in 67F" featuring expert faculty from the
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OR
@orthobulletsofficial
Here is a clip from our latest episode of CoinFlips & Controversies, “Periprosthetic Femur Fracture Nonunion in 67F” featuring expert faculty from the 2026 Tampa Revision Arthroplasty Course (taking place March 27-28, 2026 at FIVE Labs Tampa in Tampa, FL). Watch Drs. Bernasek & Lyons, discuss “Periprosthetic Femur Fracture with Plate Failure and Hypertrophic Nonunion." Click the Link in Bio to learn more about the 2026 TRAC Course and watch their full webinar on Orthobullets.
#Ficb Reel by @orthobulletsofficial - Here is a clip from our latest episode of CoinFlips & Controversies, "Periprosthetic Femur Fracture Nonunion in 67F" featuring expert faculty from the
6.1K
OR
@orthobulletsofficial
Here is a clip from our latest episode of CoinFlips & Controversies, “Periprosthetic Femur Fracture Nonunion in 67F” featuring expert faculty from the 2026 Tampa Revision Arthroplasty Course (taking place March 27-28, 2026 at FIVE Labs Tampa in Tampa, FL). Watch Drs. Lyons & Miranda, discuss “Two-Stage Treatment Strategy for Infected Periprosthetic Femur Nonunion." Click the Link in Bio to learn more about the 2026 TRAC Course and watch their full webinar on Orthobullets.
#Ficb Reel by @ortho.review - PIN Strain in Radial Head Fixation: How much is too much? Sangkamard et al. Comparative evaluation of posterior interosseous nerve strain in lateral
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OR
@ortho.review
PIN Strain in Radial Head Fixation: How much is too much? Sangkamard et al. Comparative evaluation of posterior interosseous nerve strain in lateral approach to radial head fixation: a cadaveric study. J Shoulder Elbow Surg. March 2026. #meded #orthopedics #surgery #foamed #rehabilitation

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