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Location of the Deep Plantar Artery: A Cadaveric Study

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Background

The deep plantar (D-PL) artery originates from the dorsalis pedis artery in the proximal first intermetatarsal space, an area where many procedures are performed to address deformity, traumatic injury, and infection. The potential risk of injury to the D-PL artery is concerning. The D-PL artery provides vascular contribution to the base of the first metatarsal and forms the D-PL arterial arch with the lateral plantar artery.

Methods

In an effort to improve our understanding of the positional relationship of the D-PL artery to the first metatarsal, dissections were performed on 43 embalmed cadaver feet to measure the location of the D-PL artery with respect to the base of the first metatarsal. Digital images of the dissected specimens were acquired and saved for measurement using in-house software. Means, standard deviations, and 95% confidence intervals (CIs) were calculated for all of the measurement parameters.

Results

We found that the origin of the D-PL artery was located at a mean ± SD of 11.5 ± 3.9 mm (95% CI, 4.5–24.7 mm) distal to the first metatarsal base and 18.6% ± 6.5% (95% CI, 8.1%–43.4%) of length in reference to the proximal base. The average interrater reliability across all of the measurements was 0.945.

Conclusions

This study helps clarify the anatomical location of the D-PL artery by providing parameters to aid the surgeon when performing procedures in the proximal first intermetatarsal space. Care must be taken when performing procedures in the region to avoid unintended vascular injury to the D-PL artery.

Foot and Ankle Center of Nebraska and Iowa, Omaha, NE. Dr. Whelan is now with Beloit Health System, Beloit, WI. Dr. Lazoritz is now with Clarinda Regional Health Center, Clarinda, IA.

Kentucky/Indiana Foot and Ankle Specialists, Bowling Green, KY. Dr. Kiser is now with The Jackson Clinic, Jackson, TN.

Physical Therapy/Academic, Des Moines University, Des Moines, IA.

Corresponding author: James H. Whelan, DPM, Beloit Health System, 1905 E Huebbe Parkway, Beloit, WI 53511. (E-mail: jim.h.whelan@gmail.com)