The size, branching pattern and anatomical relationships of the dorsal pedal aretery on the dorsum of the foot: a cadaver study

Abstract

Surgical techniques such as ankle arthroscopy and reconstructive flap surgery have made detailed knowledge of the dorsal pedal artery (DPA) and the deep fibular nerve (DFN) on the foot dorsum essential. The aims of this study were to determine the size, branching pattern of the DPA and its relations to the DFN and inferior extensor retinaculum (IER). Forty cadaver ankles were dissected to expose the contents of the anterior tarsal tunnel. The size of the DPA and branches were measured with a Vernier caliper and the branching pattern and relationship of the DPA to the DFN and IER were noted. The size of the DPA were 3.90 mm +/- 0.2 mm (n=40). No significant difference were seen between the sexes (T-test, p>0.05). The branching pattern of the DPA can be described in 3 categories. In 27.5% the DPA had branches above the IER, 62.5% underneath IER and 10% below the IER. No significant difference was noted between the sexes (T-test, p>0.05). The bifurcation of the DPA was mostly underneath IER (57.5%), followed by 37.5% below the IER. In 2.5% the distal branching was above the IER or absent. The bifurcation of DFN is similar as the majority (55.0%) was located underneath the IER, while 27.5% was located above the IER and 17.5% of bifurcations were observed below the IER. A distance of 7.79 +/- 2.9mm was recorded between the bifurcation of DPA and DFN. No significant difference was observed when comparing male and female as well as age groups (T-test, p>0.05). In some cases, the arterial branching lead to the formation of trunks, while 'loops' were observed in the branching pattern of the DFN. The measurements and patterns noted increases the awareness of the possible variations and should assist surgeons during vascular and reconstructive surgery