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

Abstract

Introduction:The integrity of various structures of foot is mainly depends on its vascular supply. The foot is supplied by deep plantar arterial arch formed by deep branch of dorsalis pedis artery and lateral plantar artery. So,the detailed knowledge of plantar arterial arch is necessary for advances in surgical reconstruction of foot, which in turn avoids the need for amputation. Subjects and Methods: 40 human feet procured from 20 embalmed cadavers of MVJ Medical College and Research Hospital, Bangalore used for the study. Dissection of foot was carried out and variations in the formation and branching pattern of arch are studied in detail. The results were tabulated and analysed statistically. To measure the topographical location of arch, first the length of foot was measured from tip of second toe and posterior most part of heel using flexible ruler. Depending on the length the foot is divided into 3 equal parts-Anterior, Middle and posterior parts. To know the exact location, the middle part is again divided into three equal parts-anterior middle (AM), intermediate middle (IM), posterior middle (PM). Zone in which arch located was noted down and percentage of each location is calculated. Results: The arches were classified into 6 types as per Adachi's classification.TypeB-10%,Type C-32.5%,Type D-27.5%,Type E-17.5%,Type F-12.5%.Type A was absent. In the present study majority of arches were located in the anterior middle portion of foot. Conclusion: The present study will be of great help for reconstructive surgeons, microvascular surgeons and radiologist in the successful outcome of any reconstructive and vascular surgeries.