Anatomic study of the dorsalis pedis-first dorsal metatarsal artery

The vascular anatomy of the dorsalis pedis-first dorsal metatarsal artery was investigated with regard to its general distribution and variation. We especially focused on the status of the dorsalis pedis-first dorsal metatarsal-first plantar metatarsal arterial interconnection and the sagittal course of the first dorsal metatarsal artery in order to get information for operating procedures and to understand the vascular reliability of the flap. Thirty-two feet of 17 Caucasian fixed cadavers were dissected after injection of dye or resin into the popliteal artery. The first dorsal metatarsal artery was always present. It arose from the dorsalis pedis artery in 90.6% of cases and from the lateral tarsal artery in 9.4% of cases. The critical point, where the first dorsal metatarsal artery (or the first plantar metatarsal artery in cases when the former branched from the latter) was located 10 mm distal to the tarsal-first metatarsal joint and 5.5 mm plantar from the dorsal surface of the second metatarsal bone. The medial head of the first dorsal interosseous muscle crossed dorsal to the first dorsal metatarsal artery in 31.2% of cases. The first dorsal metatarsal artery coursed superficial to the first dorsal interosseous muscle (59.4%), was partially embedded with the muscle (18.8%), or coursed along the bottom of it or below it (21.9%). In the latter type, 4 out of 7 specimens showed the thin arterial loop. The arterial network in the first interosseous space presented several anatomic variations. The standard pattern (group I) was most frequent (71.9%). Other variations (group II) could be further categorized into four subdivisions according to the pattern of the arterial interconnection.