A Study of the Dorsalis Pedis and Posterior Tibial Pulses in One Thousand Individuals without Symptoms of Circulatory Affections of the Extremities

Morrison, Hyman

doi:10.1056/nejm193302232080806

Cited by 26 publications

(3 citation statements)

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“…The vascular axes of the two saphenous nerve branches and their anastomoses with the medial malleolar network are not shown (AT, tibialis anterior m.; PT, tibialis posterior m.; other abbreviations are listed in table 1 ); d Final result after uneventful postoperative course the transverse bimalleolar axis, are in agreement with the literature [15,22,37]. In none of our specimens was the dorsal pedis a. totally absent, in contrast to s o m e p u b l i s h e d d a t a i n d i c a t i n g the "absence" of the dorsal pedis a. in 2.25% and 14.2% of specimens [10,15,22,23,27,28,31]. However, a close analysis of the literature reveals that in those series with the highest incidences of "absence" not only absent but also small arteries were excluded [15,27,37].…”

Section: Discussionsupporting

confidence: 91%

The medial malleolar network: A constant vascular base of the distally based saphenous neurocutaneous island flap

et al. 1999

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Based on 30 fresh cadaver dissections a detailed anatomic study of the medial malleolar network is presented with particular attention to the anastomoses between the latter and the vascular axis that follows the saphenous nerve. The medial malleolar network is formed by the anterior medial malleolar artery, branches from the medial tarsal arteries, the posterior medial malleolar artery and branches from the medial plantar artery. A distinct anterior medial malleolar artery and posterior medial malleolar artery could be identified in 80 and 20%, respectively, as well as constant additional small branches arising from the anterior tibial or posterior tibial artery. A constant anastomosis was found between the arcade formed by the medial tarsal arteries and the medial plantar a. in 60%, and the medial branch of the medial plantar artery in 40%, respectively. This anastomosis always gave rise to branches to the medial malleolar network. In the perimalleolar area and with regard to the great saphenous v. a larger anterior and a smaller posterior branch of the saphenous nerve was found in 100 and 90%, respectively. In all dissections, for both branches of the saphenous nerve two to four small, but distinct anastomoses between the medial malleolar network and the perineural vascular axis were identified. These constant anastomoses represent a new and reliable vascular base for the distally-based saphenous neurocutaneous island flap. Thus, the pivotal point of the flap can be chosen in the area of the medial malleolus without respecting the most distal septocutaneous anastomosis between the perineural vascular axis and the posterior tibial artery. Additionally, an illustrative clinical case is presented.

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Section: Discussionsupporting

confidence: 91%

The medial malleolar network: A constant vascular base of the distally based saphenous neurocutaneous island flap

et al. 1999

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“…Table 3 reveals that, in studies of large numbers of healthy individuals, the dorsalis pedis, posterior tibial, and femoral pulses are not palpable 8.1%, 2.9%, and 0% of the time, respectively (Table 3), 37 findings that are consistent across all age groups. 35 Even when a physician cannot palpate one of the pedal pulses of a healthy individual, however, it is usually audible by a Doppler flowmeter, the dorsalis pedis artery being congenitally absent in only 2% of extremities and the posterior tibial in 0.1%. 39,40 Anatomists dissecting normal feet have found that when the dorsalis pedis artery is small or absent, the posterior tibial artery is prominent; when the posterior tibial artery is small, the dorsalis pedis is prominent.…”

Section: Examination Of the Pedal Pulsesmentioning

confidence: 99%

Physical Examination and Chronic Lower-Extremity Ischemia

McGee

1998

Arch Intern Med

116

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“…Since in a certain number of normal individuals absent dorsalis pedis may be encountered (18,19) or absent pulses may be the result of previous arterial pathology, the validity of asymptomatic embolism could then be questioned. However, in most of the cases of the present series, clinical examination prior to the embolic accidents had listed the presence of those pulses.…”

Section: Silent or Ccsymptomatic Embolismmentioning

confidence: 99%