Anatomical study on the branching pattern of The dorsalis pedis artery and its exact position on the ankle joint

Abstract

Background: The dorsalis pedis artery (DPA) — a continuation of the anterior tibial artery — is the primary blood supply to the dorsal foot. Clinically, it aids in detecting pedal pulses and serves as a source for flaps or pedicles in bypass graft procedures, thus assisting surgeons in evaluating peripheral arterial circulation of the leg and foot, as well as patients with ischemic limbs and diabeticrelated vascular complications. The DPA’s significant anatomical variations contribute to surgical misdiagnosis of lower limb vascular conditions.

Objective: There is still a limited detailed anatomical data of the dorsalis pedis artery’s branching patterns and position of the anterior ankle, thus, the study aimed to examine the detailed anatomy and position of the DPA at the anterior ankle joint.

Methods: The study used 200 cadaveric feet. The branching patterns were categorized using a previously published classification system.

Results: Fourteen distinct dorsalis pedis artery branching patterns (Types A to N) were identified with Type H noted as the most prevalent, observed in 14.29% of cases. The average distances measured from the intermalleolar line, the DPA’s origin to the lateral and medial malleoli, were 69.30 mm, 47.19 mm, and 39.61 mm, respectively, indicating a medial skewness of the DPA’s position on the ankle joint. The mean diameter of the DPA was noted as 2.37 mm.

Conclusion: These findings provide valuable data for vascular mapping of the distal foot arteries. These insights may assist in pedal pulse detections, enhance anatomical and clinical teaching, and support surgical planning for bypass grafts in the management of ischemic limbs.