Relationship between the deep peroneal nerve and dorsalis pedis artery in the foot: A cadaveric study

Abstract

The aim of our work was to study the relationship between deep peroneal nerve (DPN) and dorsalis pedis artery (DPA) so that the frequency of these variations can be kept in mind by the angiographers and surgeons to ensure safe surgical approach during flap surgery. Ninety-two legs in 46 cadavers were dissected to study the relationship between DPN and DPA on the dorsum of the foot. The relationship of neurovascular bundle of the dorsum of the foot was classified into four types. Type I: division of the DPN distal to the midpoint between the two malleoli (observed in 26 limbs). In Type II, the division of the DPN was midway between the two malleoli (seen in 20 limbs). Both Type I and II are further divided into two subtypes (a and b) depending upon the crossing pattern of terminal branches of the DPN over DPA. In Type III, multiple branches of DPN were noted in two limbs. In Type IV, the looping pattern of DPN around the DPA was considered and was seen in eight limbs. Awareness of possible variations in the relationship of the DPA to DPN on the dorsum of the foot is important for vascular and reconstructive surgeons. Because it might help in decreasing confusion when considering treatment options like microvascular anastomosis in reconstruction of the leg.

Ultrasound-Guided Versus Anatomic Landmark-Guided Ankle Blocks

“…In another small volunteer study, there was no difference in the quality of USG deep peroneal nerve block compared with the ALG technique, although onset was faster in the USG group. 8 Nevertheless, we find US useful in locating both the nerve, which is prone to anatomic variation, 18 and also the anterior tibial artery, which again is not always readily palpable, 19 especially at the intermalleolar line. Ultrasound may also help avoid unintentional arterial puncture and injection.…”

Paresthesia and hypesthesia in the dorsum of the foot as the presenting complaints of a ganglion cyst of the foot

“…The lateral terminal branch crosses the tarsus deep to the extensor digitorum brevis, and supplies this muscle. The medial terminal branch usually runs distally on the dorsum of foot lateral to the dorsalis pedis artery (Ranade et al, 2008), connecting with the medial branch of the superficial fibular nerve in the first interosseous space (Fig. 3).…”

Clinically Important Anatomical Variation of Cutaneous Branches of Superficial Peroneal Nerve in the Foot

“…In such surgical procedures possibility the intermediate dorsal cutaneous branch of SPN supplying the first web space as in present case should be kept in mind and that area also should be included in the flap to avoid damaging the twigs supplying that area. Awareness of possible variations in the relationship of the deep peroneal nerve to dorsalis pedis artery on the dorsum of the foot is important for vascular and reconstructive surgeons as it might help in decreasing confusion when considering treatment options like microvascular anastomosis in reconstruction of the leg [10]. However, in the present case the dorsalis pedis artery is related to the medial dorsal cutaneous branch of SPN which supplies the first web space instead of deep peroneal nerve.…”