Anatomic Study of Blood Supply of the Dorsum of the Foot and Ankle

Purpose: This project was to study the different patterns of the anterior tibal and dorsalis pedis arteries in relation to the blood supply of the dorsum of the foot and ankle. Methods: A reliable sample of 150 human embalmed cadavers was dissected. Results: Four different patterns were identified. The dorsalis pedis artery was most frequently (287 cases, 95.7%) found to be the continuation of the anterior tibial artery distal to the ankle, and lay between the tendon of extensor hallucis and the first tendon of extensor digitorum longus. The other 13 cases (4.3%) showed 3 variant patterns of the anterior tibial-dorsalis pedis vascular axis: the anterior tibial artery took a more lateral course, passing in front of the lateral malleolus (6 cases, 2%); the perforating branch of the peroneal artery assumed the expected course of the dorsalis pedis artery (4 cases, 1.3%); the anterior tibal artery gave a lateral branch that replaced the perforating branch of the peroneal artery to supply the lateral aspect of the ankle (3 cases, 1%). Conclusion: Arterial variations of the anterior tibial-dorsalis pedis axis occurred in almost 5% of cases. Clinical Relevance: An awareness of the existence of such variations is helpful during a preoperative assessment and could prevent injury during surgery.