[Interosseous dorsal artery of the first intermetatarsal space: anatomic variations and value in functional vascular...

The first dorsal metatarsal artery (MDA) is usually described as the last collateral branch of dorsalis pedis artery (DPA, which anastomoses with the lateral plantar branch of the posterior tibial artery (PTA). Doppler assessment on DMA of a flow does not always mean that DPA is free, but may show a functional plantar arch. The aim of this study was to determinate the patency rate of this plantar arch and to appreciate the part of DPA in the vascularisation of the foot. Anatomical descriptions were compared with our own dissections, (25 cadavers and 55 arteriographies in fetus), angiographic analysis and vascular plastic casts. The functional aspect of this study was made by Doppler examination of DMA using alternative or simultaneous compression of the main arteries of the ankle, until doppler curves were canceled. That was done on healthy volunteers and arteriosclerotic patients. The results show that, from the anatomical viewpoint, the plantar arch is almost always present, since it was found in 88% of adult pieces. Nevertheless, on Doppler examination, the plantar arch was found functional only in 64% of healthy people. The difference between the two rates emphasizes the fact that anatomical anastomosis are note always open, according to the subject and probably to the age. Looking after MDA permeability in patients with arteriosclerosis leads to point out the main vascular access to the foot, for limb salvage, and the leading part of distal anastomosis to keep good trophicity of the toes.