For procedures that require anesthesia from midmiddle phalanx distally (e.g., nail bed regions and distal interphalangeal joint distributions and fusions) digital anesthesia can be easily achieved by single volar injection technique. A, Just proximal to palmar digital crease, through pinched skin 3 to 5 mL of local anesthetic is injected superficial to flexor sheath. B, Anesthesia achieved (colored area) from block of proper and dorsal sensory digital nerve branches. Note, if more proximal anesthesia is needed, additional block can be given at metacarpophalangeal joint dorsally as shown.