The Anatomy of the Plantar Arterial Arch

Abstract

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.

Surgical Implications of Variations and Location of Plantar Arterial Arch: An Anatomical Study

“…Knowledge of origin of plantar metatarsal arteries is important to know the amount of damage of tissues, in case if all the plantar metatarsal arteries arises from either dorsalis pedis artery or lateral plantar artery then occlusion of these arteries will lead to extensive tissue damage. [11] Because of the advances of microvascular surgeries, the frequency of amputations can be reduced by bypass surgeries .O'Brien et al was the first one to use dorsalis pedis artery as the neurovascular flap in vascular surgeries. [12] It can also be used as island flap to cover the ankle or heel defects and as a free flap for palm defects.…”