Anatomy of the Plantar Arterial Arch

NewsBot · Apr 16, 2015

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The Anatomy of the Plantar Arterial Arch
A. Kalicharan et al
Int. J. Morphol., 33(1):36-42, 2015. (full text)
SUMMARY:

The plantar arterial arch provides the dominant vascular supply to the digits of the foot, with variability in length,
shape, and dominant blood supply from the contributing arteries. According to the standard definition, the plantar arterial arch is formed
from the continuation of the lateral plantar artery and the anastomoses between the deep branch of dorsalis pedis artery. In this study, 40
adult feet were dissected and the plantar arch with variations in shape and arterial supply was observed. The standard description of the
plantar arch was observed in 55% of the specimens with variations present in 45%. Variations in terms of shape were classified into three
types: Type A (10%): plantar arterial arch formed a sharp irregular curve; type B (60%): obtuse curve; type C (3%): spiral curve.
Variation in the dominant contributing artery was classified into six types: type A (25%), predominance in the deep branch of dorsalis
pedis artery supplying all digits; type B (5%), predominance in the lateral plantar artery supplying digits 3 and 4; and type C (20%),
predominance in the deep branch of dorsalis pedis artery supplying digits 2 to 4; type D (24%), equal dominance showed; type E (10%),
predominance in the lateral plantar artery supplying digits 3 to 5; and type F (21%), predominance of all digits supplied by lateral plantar
artery. The foot was divided into three parts to determine the location of the plantar arterial arch. The second part was further divided into
three parts: middle anterior (90%), intermediate middle (10%), and middle posterior (0%). Knowledge of the vascular anatomy of the
plantar arterial arch is crucial for understanding sites of partial amputations.
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NewsBot · Sep 26, 2019

Location of the Deep Plantar Artery: A Cadaveric Study.
Whelan JH et al
J Am Podiatr Med Assoc. 2019 Sep 24

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 to injury of 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. Images of the dissected specimens were digitally acquired and saved for measurement using in-house written software. The mean, standard deviation and 95% confidence intervals were calculated for all measurement parameters.

RESULTS:
We found that the origin of the D-PL artery was located at 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% to 43.4%) its length in reference to the proximal base. The average inter-rater reliability across all measurements was 0.945.

CONCLUSIONS:
Our study helps to clarify the anatomic 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.
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NewsBot · Jun 27, 2022

Sonography of Lateral Plantar Artery Pseudoaneurysm Caused by Knife Cut Injury
Tony Y. Li, RDMS, RVT, RMSK, CRGS, CRVS
Journal of Diagnostic Medical Sonography June 21, 2022

Pseudoaneurysms of the lateral plantar artery (LPA) are rare. In this case study, a very rare case of a pseudoaneurysm of the LPA, caused by a knife cut, is reported. A female adult patient presented with a growing lump in the arch of the left foot for 4 weeks. She had an accidental steak knife stab her on the arch of the left foot and had the cut sutured 5 weeks prior. The physical examination revealed a warm, pulsatile, and tender lump without a clear border deep to the scar in the lateral arch. Duplex ultrasonography (DUS) detected a cavity with the wall uneven in thickness and the outer wall undistinguished. Doppler demonstrated a typical Yin-yang sign inside the cavity and a neck-like structure connecting the cavity to an artery along the path of the LPA, suggesting that this was a LPA pseudoaneurysm, caused by penetration trauma. Later, the patient received priority surgery to have the pseudoaneurysm repaired.
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NewsBot · Sep 18, 2022

Avoiding the Deep Plantar Arterial Arch in Transmetatarsal Amputations: A Cadaver Study
James H Whelan et al
J Am Podiatr Med Assoc. 2022 Apr 27;112(2):20-298

Background: The deep plantar arterial arch (DPAA) is formed by an anastomosis between the deep plantar artery and the lateral plantar artery. The potential risk of injury to the DPAA is concerning when performing transmetatarsal amputations, and care must be taken to preserve the anatomy. We sought to determine the positional anatomy of the DPAA based on anatomical landmarks that could be easily identified and palpated during transmetatarsal amputation.

Methods: In an effort to improve our understanding of the positional relationship of the DPAA to the distal metatarsal parabola, dissections were performed on 45 cadaveric feet to measure the location of the DPAA with respect to the distal metatarsal epiphyses. Images of the dissected specimens were digitally acquired and saved for measurement using in-house-written software. The mean, SD, SEM, and 95% confidence interval were calculated for all of the measurement parameters and are reported on pooled data and by sex. An independent-samples t test was used to assess for sex differences. Interrater reliability of the measurements was estimated using the intraclass correlation coefficient.

Results: The origin of the DPAA was located a mean ± SD of 35.6 ± 3.9 mm (95% confidence interval, 34.5-36.8 mm) proximal to the perpendicular line connecting the first and fifth metatarsal heads. The average interrater reliability across all of the measurements was 0.921.

Conclusions: This study provides the positional relationship of the DPAA with respect to the distal metatarsal parabola. This method is easily reproducible and may assist the foot and ankle surgeon with surgical planning and approach when performing partial pedal amputation.
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