VARIATIONS OF THE ARTERIAL ANATOMY OF THE FOOT

Reconstruction of the arteries of the foot in patients with severe chr onic arterial occlusive disease has become a routine and valuable proc edure. However, it is frequently difficult to select the optimal site for the distal arterial anastomosis. In order to determine the most im portant anatomic variations of foot arteries and the relationship of t he dorsalis pedis artery to crossing tendons, the following study was performed in 30 cadaver limbs of 17 persons (9 men and 8 women). Their mean age at death was 69.8 years (range: 42 to 93 years). Methods to evaluate anatomy included anatomic dissection, arteriography, and prep aration of corrosion cast models. The latter was performed by injectio n of liquid plastic and catalyst into the tibial arteries followed by chemical debridement of the soft tissue of the foot. Photographs of th e corrosion cast models were taken at various stages of soft tissue di ssolution. The dorsalis pedis artery was absent in 6.7% of the cases, and the arcuate artery was absent in 33%. The dorsalis pedis artery ar ose from the peroneal artery in 6.7%. The dorsalis pedis artery crosse d under the extensor hallucis longus tendon at the ankle in 54%, above the ankle in 43%, but below the ankle in only 3%. Our study suggests that the optimal site for the dorsalis pedis artery anastomosis on the foot is the segment distal to the ankle.