Where is dorsalis pedis artery

Updating… Please wait. Unable to process the form. Check for errors and try again. Thank you for updating your details. Log In. Sign Up. Become a Gold Supporter and see no ads. Log in Sign up. Articles Cases Courses Quiz. About Recent Edits Go ad-free. Edit article. View revision history Report problem with Article. It may be absent 1. Sometimes an enlarged perforating branch of peroneal artery continues as dorsalis pedis artery 2 , 3.

There are reports of lateral deviation and bifurcation of the dorsalis pedis artery 4. The dorsalis pedis artery is best for pedal revascularization since it is the largest artery distal to the ankle joint 5. The dorsalis pedis flap is one of the most commonly used foot flaps in traffic accidents, electrical burns, industrial injury, ulcer etc.

Fasciocutaneous flaps are used for covering defects of the hand 6. First dorsal metatarsal artery is the most widely used arterial pedicle in toe to finger transplants 7 , 8. More recently dorsalis pedis fasciocutaneous flaps are used in the reconstruction of oral cavity defects in cases of oral cancers patients 9.

Osteomyocutaneous peroneal artery perforator flap is being used for reconstruction of the skull base after craniofacial resection in the treatment of malignant cancers which results in the defects of the skull base In diabetic patients, critical limb ischemia due to occlusions of the lower limb vessels is becoming more common, therefore knowledge of these arteries is needed in order to avoid amputations Aneurysms and pseudoaneurysms of the dorsalis pedis artery are rare vascular complications usually caused by traumatic injury or iatrogenic intervention especially after ankle arthroscopy The aim of the study was to see variations in the origin, course and branching pattern of the dorsalis pedis artery.

The compartments of leg and dorsum of foot were dissected along with tracing the anterior tibial artery and dorsalis pedis artery from origin till termination.

Variations in the origin, course and branching pattern of dorsalis pedis artery were observed and photographed. The normal branching pattern of dorsalis pedis artery was found in 27 limbs out of 40 specimens. Variations observed in 13 limbs were as follows:. In one specimen, there was bilateral anomalous origin of dorsalis pedis artery from peroneal artery. In both the limbs peroneal arteries were as big as posterior tibial arteries and anterior tibial arteries were smaller in diameter.

Anterior tibial artery ended just above the ankle joint. Enlarged perforating branch of peroneal artery after passing through the lower opening in the interosseous membrane, descended anterior to inferior tibiofibular syndesmosis and continued as dorsalis pedis artery. It gave a branch to the lateral side of the dorsum of foot. Main artery runs deep to tendons of peroneus tertius and extensor digitorum longus and then between extensor hallucis longus and extensor digitorum longus and gave first dorsal metatarsal artery and entered sole as deep plantar artery Fig.

Showing bilateral anomalous origin of dorsalis pedis artery from enlarged perforating branch of peroneal artery and absence of arcuate artery in the right limb and dorsal metatarsal arteries arising from dorsalis pedis artery.

In another specimen, anterior tibial artery divided into two branches superficial and deep above the talocrural joint, and both branches entered dorsum as dorsalis pedis arteries—double dorsalis pedis artery. The deep branch gave one more branch and all three ran side by side to reach the first dorsal intermetatarsal space. The middle one dipped into the first dorsal metatarsal space as deep plantar artery and gave the first dorsal metatarsal artery Fig.

Showing double dorsalis pedis artery. In another specimen, there was bilateral deviation towards lateral side and it divided into two branches. The medial branch continued as dorsalis pedis artery passing deep to the tendons of peroneus tertius and extensor digitorum longus and gave first dorsal metatarsal artery and entered sole as deep plantar artery. But the medial branch in right limb was extremely thin, could not be traced beyond the first dorsal metatarsal space, when compared to the left limb Fig.

Showing bilateral deviation and bifurcation of dorsalis pedis artery and extremely thin dorsalis pedis artery in right limb. In one specimen, the dorsalis pedis artery was trifurcating into arcuate artery on the lateral side, first dorsal metatarsal artery on the medial side and middle one continued as dorsalis pedis artery just distal to ankle joint.

Traced distally, the dorsalis pedis artery, gave second dorsal metatarsal artery and deep plantar artery and entered sole in the second dorsal inter metatarsal space instead of first space Fig. Showing trifurcation of dorsalis pedis artery and entering sole in the II inter metatarsal space. In seven specimens, arcuate artery was absent. Since arcuate artery was absent, there were variations in the origin of dorsal metatarsal arteries.

In the same right anomalous origin of dorsalis pedis artery by enlarged perforating branch of peroneal artery specimen, there was absence of arcuate artery. The 2nd, 3rd and 4th dorsal metatarsal arteries were taking origin from the dorsalis pedis artery directly. In one specimen, 2nd and 3rd dorsal metatarsal arteries arising directly from dorsalis pedis artery Fig. The 2nd, 3rd and 4rd dorsal metatarsal arteries arising from the plantar arch in four specimens Figs.

Dorsalis pedis artery was slightly tortuous and giving rise to 2nd dorsal metatarsal artery Fig. The 2nd dorsal metatarsal artery from plantar arch, 3rd and 4th dorsal metatarsal arteries from lateral plantar artery Fig. Showing 2nd and 3rd dorsal metatarsal arteries arising directly from the dorsalis pedis artery.

DMA-Dorsal metatarsal arteries. Absence of arcuate artery with dorsal metatarsal arteries arising from plantar arch. Dorsal metatarsal arteries arising from plantar arch.

Absence of arcuate artery with 2nd dorsal metatarsal artery arising from dorsalis pedis artery, 3rd and 4th dorsal metatarsal arteries from plantar arch.

Absence of arcuate artery with 2nd dorsal metatarsal artery arising from plantar arch, 3rd and 4th dorsal metatarsal arteries from lateral tarsal artery. Abnormal or variations in the branching patterns of the popliteal artery results due to arrest of normal development of limb vessels according to Senior The lower limb vessels arise from sciatic artery, a branch of the umbilical artery.

Sciatic artery persists in most vertebrates, but in mammals the femoral artery, as the continuation of the external iliac artery, becomes the main artery for the lower limbs. Anastomoses are formed between the sciatic and the femoral arteries. When the femoral artery continues as the popliteal artery, the sciatic artery regresses.

Its middle and distal portions persist to form the popliteal and peroneal arteries, whereas the anterior tibial and posterior tibial arteries are derived from the femoral artery.

So regression and persistence of the sciatic artery and its connection with the femoral artery in the popliteal region are the main reasons for the variations in the arteries of the leg Hypoplasia of one of these vessels can cause abnormal blood supply to the foot Tuncel et al.

Cheung et al. But according to Yamada et al. In a study by Vijayalakshmi et al. In present study, there was bilateral anomalous origin of dorsalis pedis artery by the peroneal artery. Similar anomalous origin was described bilaterally by Tuncel et al.

Vijayalakshmi et al. But in the present study, there were three arteries running parallel to each other and the middle one continued as deep plantar artery after giving first dorsal metatarsal artery. Both superficial and deep arteries gave lateral tarsal arteries. But medial tarsal was arising from the deep branch and arcuate artery from the superficial branch. This type of variation has not been reported till now in the literature. Lateral deviation and bifurcation of dorsalis pedis artery has been reported by Bailleul et al.

In the present study also dorsalis pedis artery showed bifurcation just distal to ankle joint, the medial branch continued as dorsalis pedis artery after passing deep to the tendons of peroneus tertius and extensor digitorum longus and returned to the first dorsal inter metatarsal space in the distal part of the foot.

In another study by Kesavi et al. If the course of dorsalis pedis artery is oblique it may result in impaired healing in fracture of distal end of tibia, fibula and malleoli due to external or internal fixation 3. Anomalous origin of dorsalis pedis artery like this and lateral deviation of dorsalis pedis artery passing anterior to inferior tibiofibular syndesmosis may get damaged during ankle arthroscopy. Trifurcation of dorsalis pedis artery is a rare variation not reported so far in the literature.

Lateral branch was arcuate artery, medial branch was first dorsal metatarsal artery and middle one continued as dorsalis pedis artery. After giving second dorsal metatarsal artery it entered sole as deep plantar artery in the second dorsal inter metatarsal space instead of first dorsal intermetatarsal space.

This variation is also not mentioned in the literature. However, Nilesh et al. But in the present case, second dorsal metatarsal artery was arising from dorsalis pedis artery even in the presence of arcuate artery is not reported in the literature.

In the present study, we also got another not described variation, that is, in the absence of arcuate artery the 2nd 3rd and 4th dorsal metatarsal arteries were arising from dorsalis pedis artery and not from the lateral tarsal artery. According to Nilesh et al. But according to DiLandro et al. It was the lateral tarsal artery which gave dorsal metatarsal 2nd, 3rd and 4th arteries more frequently Conclusion: The dorsal most prominence of the navicular bone provides a bony landmark to readily locate the dorsalis pedis artery.

Reliability of the examination may be increased as to the patency of the dorsalis pedis artery by using this dependable anatomic landmark. Abstract Introduction: The unreliability of the pulse examination of the foot has primarily been due to variability of technique between examiners. Publication types Comparative Study.