Lost and Found: The Broken Tip of a Posterior Tibial Nerve Catheter

Catheter breakage is a rare complication of continuous peripheral nerve blocks. Retained fragments pose a significant technical challenge, particularly when they migrate from the insertion site. We report a 39-year-old woman with Fabry disease and chronic foot pain refractory to pharmacologic therapy who, after a successful diagnostic posterior tibial nerve block, received a continuous peripheral nerve catheter. She initially experienced excellent analgesia but, by Day 4, developed severe neuropathic symptoms; imaging showed proximal migration of a catheter fragment. Computed tomography and fluoroscopy guided surgical retrieval of the fragment was performed. This case highlights the need for early recognition of catheter-related complications, precise localization with advanced imaging, and timely surgical intervention to reduce adverse outcomes from retained catheter fragments.