Vascular anatomy of the first metatarsal bone and surgical implications

NewsBot · Sep 20, 2020

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Vascular anatomy of the first metatarsal bone and surgical implications according to the severity of hallux valgus deformity: A cadaveric study
SérgioSoares et al
Foot and Ankle Surgery; 18 September 2020

Highlights
•First metatarsal head receives an important blood supply through dorsal plexus.
•Vascular landmarks change in function of the hallux valgus’ severity.
•Proximal safe zone is estimated 10-15 mm distal to the FTMJ.
•Distal danger zone is estimated 20-25 mm proximal to the FMPJ.
•Surgical technique should be adapted to every foot, according to its deformity.
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Background
Vascular injury after hallux valgus surgery is a rare condition but serious complications can ensue.

Methods
We performed an anatomical study using 26 cadaveric lower extremities. We enhanced first metatarsal bone’s (FMB) vascularization by injecting latex. Each specimen was classified according to the severity of hallux valgus deformity (HVD). Then we measured two distances: one between the first tarsometatarsal joint (FTMJ) to the first dorsal branch’s origin, the other between the first metatarsophalangeal joint (MTP) to the dorsal plexus’s origin.

Results
The distance between the FTMJ and the first dorsal branch to the FMB ranges from 10 mm in normal feet to 15 mm in severe deformed feet. The distance between the MTP and the dorsal plexus’ origin ranges from 20 mm in normal feet to 25 mm in severe deformed feet.

Conclusions
Understanding the foot’s vascular anatomy has allowed us to adapt surgical landmarks to the severity of the HVD and to avoid post-operative complications.
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