Avoiding the Deep Plantar Arterial Arch in Transmetatarsal Amputations: A Cadaver Study

Area of Science:

• Anatomy
• Surgical Anatomy
• Vascular Anatomy

Background:

• The deep plantar arterial arch (DPAA) is formed by the deep plantar artery and lateral plantar artery.
• Injury risk to the DPAA during transmetatarsal amputations necessitates precise anatomical knowledge.
• Understanding DPAA position is crucial for preserving anatomy during surgery.

Purpose of the Study:

• To determine the positional anatomy of the DPAA.
• To identify easily palpable anatomical landmarks for surgical reference.
• To aid in surgical planning for transmetatarsal amputations.

Main Methods:

• Dissections of 45 cadaveric feet.
• Measurement of DPAA location relative to distal metatarsal epiphyses.
• Digital image acquisition and analysis using custom software.

Main Results:

• The DPAA origin is located 35.6 ± 3.9 mm proximal to the line connecting the first and fifth metatarsal heads.
• High interrater reliability (0.921) for measurements.
• Detailed positional data provided relative to the distal metatarsal parabola.

Conclusions:

• The study establishes the positional relationship of the DPAA to the distal metatarsal parabola.
• This reproducible method can assist foot and ankle surgeons in surgical planning.
• Enhanced understanding aids in preserving the DPAA during partial pedal amputations.