Variations in the origin, course and branching pattern of dorsalis pedis artery with clinical significance

Pulsations of the dorsalis pedis artery are commonly used to evaluate the peripheral arterial diseases like thromboangiitis obliterans (TAO) or Buerger's disease, in lower limbs. Dorsalis pedis artery is a direct extension from the anterior tibial artery and major vascular supply for the dorsum of the foot. But arterial variations in lower limbs are common due to rich distal anastomoses around the ankle joint. Absence of dorsalis pedis arterial pulse does not indicate peripheral arterial disease always as it is sometimes replaced by the enlarged perforating branch of peroneal artery, it may be absent or very thin, deviate laterally on the dorsum of foot. Aim of the present study is to observe the variations in origin, course and branching pattern of dorsalis pedis artery because of its clinical significance. During routine dissection of lower limbs for undergraduates we came across rare variations in the dorsalis pedis artery in its origin, course and branching pattern. Normal anatomic description was found in 27 limbs. In 13 specimens we noted variations, includes bilateral anomalous origin of dorsalis pedis artery, bilateral lateral deviation of dorsalis pedis artery, double dorsalis pedis artery, trifurcation of dorsalis pedis artery and absence of arcuate artery. Knowledge about the arterial variations around the ankle is important to orthopaedic, vascular surgeons and radiologists to prevent complications during surgical interventions.