A Description of the Size and Distal Branching Pattern of the Dorsalis Pedis Artery: A Cadaveric Study (original) (raw)
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Anatomy of the Dorsalis Pedis Artery
The dorsalis pedis artery (DPA) is the largest blood vessel distal to the ankle joint. It is the continuation of the anterior tibial artery (ATA) and runs along the dorsum of the foot until the 1st intermetatarsal space. The DPA gives rise to five branches, viz. medial tarsal, lateral tarsal, arcuate, deep plantar and dorsal metatarsal arteries. Given the vast blood supply provided by the DPA, in the current era of microvascular surgery, the anatomy of the DPA is of increasing interest to anatomists, surgeons and angiographers. The aim of this study was to outline the course, origin, branching patterns and possible variations of the DPA. The present study included the dissection of forty (n=40) cadaveric specimens of the lower limb region (Left: 25; Right: 15). The origin, course and branching patterns of the artery were studied. These morphological parameters were further analysed with regard to laterality to determine if a correlation existed. The Pearson Chi-square test was employed and a p value of less than 0.05 was deemed statistically significant. Although the DPA was present in 97.5 % of cases, it followed the standard anatomical description in only 42.5 % of cases. The DPA originated from the peroneal artery in 5 % of cases. In 25 % of cases, DPA deviated laterally. Variation in the branching pattern of the DPA, which was recorded in 50 % of cases, was further classified according Types 1 to 6. The findings of this study correlated closely with most previous studies. However, the incidence of lateral deviation of the DPA was higher in this study as well as the incidence of Type 1 variation in branching pattern. Additionally, this study proposes a novel variation in branching pattern which has been termed Type 6, which displays a recurrent branch of the Type 5 variation. The DPA has an important role in a clinical setting since the DPA flap is employed in reconstructive surgeries and peripheral circulation may be assessed by the palpation of the DPA pulse. Therefore, a thorough understanding of the anatomy of the DPA is of prime importance to podiatrists, surgeons, anatomists and angiographers.
Anatomical study of Dorsalis pedis Artery and Its Clinical Correlations
2011
INTRODUCTION To evaluate patients with arterial disease, palpation of peripheral arterial pulse is commonly used. In lower limb, palpation of dorsalis pedis artery is used to evaluate the arteriosclerotic diseases. Dorsalis pedis artery is the main source of blood supply to the foot. A knowledge about the origin, course and branching pattern of this artery is essential, as it forms the stem for one of the major myocutaneous flaps, used for ankle surgeries in plastic and reconstructive surgeries. Fifty free lower limbs were dissected and the origin, course and branching pattern of dorsalis pedis artery were studied. 50 free lower limbs were collected from the anatomy dissection hall. The dorsalis pedis artery was dissected and its origin, course and branching pattern were studied. In the present study dorsalis pedis artery was found to have a normal course and branching pattern in 56%, variation in origin in 8%, variation in branching pattern in 16%, absence of the artery in 2% and d...
Study of Branching Pattern of Dorsalis Pedis Artery and its Clinical Significance
Objective: To study the branching Patterns of the Dorsalis pedis artery. Method: The study was conducted in the Department of anatomy, TNMC & BYL Ch. Hospital, Mumbai. Sixty cadaveric lower limbs were dissected below ankle and dorsalis pedis artery was traced to all its branches. Results: We observed 10 different branching patterns of dorsalis pedis artery, some of which were not reported in literature. Conclusion: Dorsalis pedis artery have variations in branching patterns. Knowledge of these variations will help surgeons for planning and better outcome of surgeries involving foot.
Relationship of the dorsalis pedis artery to the tarsal navicular
The Journal of foot and ankle surgery : official publication of the American College of Foot and Ankle Surgeons
When undertaking surgical maneuvers about the midfoot, caution must be used to avoid injury to the dorsalis pedis artery, which courses along the dorsum of the foot on the dorsolateral aspect of the tarsal navicular. In an effort to better understand the relationship of the course of the dorsalis pedis artery relative to the tarsal navicular, 128 embalmed feet (31 [48.4%] female and 33 [51.6%] male cadavers aged 15 to 91 years) were measured. The dorsalis pedis artery was dissected from its origin to its termination (i.e., the first dorsal metatarsal artery and the deep plantar perforating artery), and the distance from the medial cortex of the navicular tuberosity to the medial margin of the artery and the location of the artery as a percentage of the medial-to-lateral width of the navicular were measured. In the male cadaver specimens, the distance from the navicular tuberosity to the dorsalis pedis was 23.75 ± 3.1 mm, the width of the navicular was 37.41 ± 5.0 mm, and the locatio...
Anatomic Study of Blood Supply of the Dorsum of the Foot and Ankle
Arthroscopy: The Journal of Arthroscopic & Related Surgery, 2006
This project was to study the different patterns of the anterior tibal and dorsalis pedis arteries in relation to the blood supply of the dorsum of the foot and ankle. Methods: A reliable sample of 150 human embalmed cadavers was dissected. Results: Four different patterns were identified. The dorsalis pedis artery was most frequently (287 cases, 95.7%) found to be the continuation of the anterior tibial artery distal to the ankle, and lay between the tendon of extensor hallucis and the first tendon of extensor digitorum longus. The other 13 cases (4.3%) showed 3 variant patterns of the anterior tibial-dorsalis pedis vascular axis: the anterior tibial artery took a more lateral course, passing in front of the lateral malleolus (6 cases, 2%); the perforating branch of the peroneal artery assumed the expected course of the dorsalis pedis artery (4 cases, 1.3%); the anterior tibal artery gave a lateral branch that replaced the perforating branch of the peroneal artery to supply the lateral aspect of the ankle (3 cases, 1%). Conclusion: Arterial variations of the anterior tibial-dorsalis pedis axis occurred in almost 5% of cases. Clinical Relevance: An awareness of the existence of such variations is helpful during a preoperative assessment and could prevent injury during surgery.
Anatomical variation of the Dorsalis pedis artery in a South African population – A Cadaveric Study
The Foot, 2018
Background: The dorsalis pedis artery is responsible for blood supply to the dorsal aspect of the foot and is vital in the clinical assessment of the arterial supply thereof. Clinical assessment should consider anatomical variations of dorsalis pedis artery. Clearly, a thorough understanding of the potential variations of the vasculature in the area is important for a precise clinical assessment of arterial supply to the foot. The aim of this study was to investigate the different branching patterns of the dorsalis pedis artery that exist in a South African population. Methods: A Cadaveric study in which a total of 33 dissected lower limbs (27 adult cadavers and 6 partial wet lower limb specimens) of a South African population sample were studied. The course and branching pattern of the dorsalis pedis artery were photographed and documented. Results: Nine variations of the dorsalis pedis artery were recorded, with the standard branching pattern being the most common with an incidence of 36.36% and a completely absent dorsalis pedis artery variation was noted in 6.06% of the sample. Conclusion: Nine variations of the arterial anatomy of the dorsalis pedis artery were identified in this current study. Each of these may possibly alter the location or strength of the dorsalis pedis pulse affecting clinical assessment outcomes. Knowledge of dorsalis pedis variations may be useful to clinicians when making clinical decisions.
Anatomical Variations of the Dorsalis Pedis Artery in a Thai Population
International Journal of Morphology, 2022
The dorsalis pedis artery (DPA) is a vital artery that supplies the foot and ankle area which is clinically important for palpating when taking the pulse. This research was performed on fresh cadaveric dissection of 40 legs by injecting paint into popliteal artery for tracking the dorsalis pedis artery and its branches. The present research revealed that the Thai population has an anatomical variation and different location of the DPA and exact location of DPA for estimating the location of the DPA and may have clinical implications. The statistically descriptive analysis elucidated the distances of the DPA to the lateral malleolus and medial malleolus which were 51.48 ± 7.27 mm and 42.62 ± 11.40 mm, respectively. The distance of the extensor hallucis longus (EHL) to the DPA was 14.29 ± 4.11 mm. The length of the dorsalis pedis artery which measured from artery on intermalleolar line to its dipping in 1st intermetatarsal space to be 122.03 ± 21.07 mm. The arcuate loop which is anastomosis U-loop of lateral tarsal arteries of the DPA was found 55 % in Thais population. There were no statistically significant differences of all parameters between the side and sex in DPA consideration. An understanding of the variations of the anatomical vasculature of DPA is essential for precise clinical assessment because exact anatomical knowledge and location can contribute to the pulse taking and be applied in surgical procedure.
International journal of scientific research, 2017
Introduction: Palpation of peripheral arterial pulse is commonly used to evaluate the patients with arterial diseases. Dorsalis pedis artery is commonly used to evaluate arteriosclerotic diseases in the lower limb. Aim: Aim of the present study is to observe the course of fibular (peroneal) artery continuing as dorsalis pedis artery associated with hypoplastic anterior tibial artery as it is a rare anatomical variation. Material and Methods: Fifty (50) formalin embalmed lower limb specimens were dissected and studied to observe the anatomical variation of fibular (peroneal) artery continuing as dorsalis pedis artery associated with hypoplastic anterior tibial artery. Results: In one specimen of lower limb the fibular (peroneal) artery was larger than usual and crossed the lower end of interosseous membrane and continued as dorsalis pedis artery. Posterior tibial artery had a normal course and divided distally into medial and lateral plantar arteries, however, the anterior tibial artery was found to be hypoplastic. Conclusions: A good knowledge about the arterial variations around the ankle is important to the vascular and orthopaedic surgeons to prevent the occurrence of any complications during arterial reconstructive studies.
Online Journal of Health & Allied Sciences, 2017
During routine dissection, we came across multiple variations in the dorsum of the right foot. Dorsalis pedis artery (DPA) presented with an unusual branching pattern. The arcuate artery was completely absent, and hence three tarsal branches arose from lateral side of DPA. The first branch continued as first dorsal metatarsal artery, the second branch continued as the second dorsal metatarsal artery, and the third branch continued as third dorsal metatarsal artery which also provided a small twig to the fourth intermetatarsal space as the fourth dorsal metatarsal artery. We also observed the unique presence of extensor hallucis brevis muscle with the origin from the medial part of superior surface of the calcaneus and inserted to proximal phalanx of great toe. Since the DPA was just beneath this muscle, anomalous presence of the muscle may lead to compression of DPA. Awareness regarding such variations is critical for angiographers, vascular surgeons, reconstructive and plastic surgeons.
The island hemisoleus flap on distal vascular pedicle: anatomical bases and clinical applications
Surgical and Radiologic Anatomy, 2009
The coverage of skin defects of the ankle and of the distal fourth of the leg remains a diYcult problem despite progress in reconstructive surgery. The aim of our study was to establish an arterial map of the lateral head of the soleus muscle, to compare it with the existing data in order to investigate the possibility of raising a Wbular artery-based pedicle island reverse Xow Xap. It has the theoretical advantage over its medial counterpart of sparing the main arterial axis of the leg and foot. The anatomical study was undertaken on 15 fresh cadavers, 8 left and 7 right randomly chosen lower extremities from diVerent subjects. For each calf, the following measurements were obtained: Wbular length from the Wbular head to the tip of the lateral malleolus; length of the lateral head of the soleus from its most proximal insertion point on the Wbula to the most proximal part of the ending of the muscle belly on the Achilles tendon; width of the lateral head of the soleus; distance between the origin of the Wbular artery and the tip of the Wbular head; number and height of the pedicles for the lateral soleus, taking as reference their origin from the Wbular artery. The mean dimensions of the muscle belly of the lateral soleus were 218 mm in length (between 160 and 270) and 73 mm in width (58-95). In all the examined lower extremities, we found a main pedicle for the lateral soleus emerging from the Wbular artery; and in all cases the blood supply of the proximal part of the muscle was of a segmental distribution by way of multiple branches originating from the Wbular artery. Then the Xaps were raised with a distal pivot point represented by the perforating branch of the Wbular artery. In all the cases, the Xap would have covered an ankle or a dorsal foot defect up to the metatarsal heads.