CC BY-NC-ND 4.0 · Indian J Plast Surg 2009; 42(01): 018-021
DOI: 10.1055/s-0039-1699306
Original Article
Association of Plastic Surgeons of India

The relationship between the deep fibular nerve and the dorsalis pedis artery and its surgical importance

R. Chitra
1  Assistant Professor, Department of Anatomy, Siddhartha Medical College, Vijayawada, Andhra Pradesh, India
› Author Affiliations
Further Information

Publication History

Publication Date:
15 January 2020 (online)

ABSTRACT

The aim of this study was to demonstrate the relationship between the deep fibular nerve and the dorsalis pedis artery to provide useful anatomical knowledge for safe surgical approaches in plastic surgery. The dissection of 30 cadaver lower limbs was undertaken to describe the relationship of the deep fibular nerve to the dorsalis pedis artery in the anterior tarsal tunnel and on the dorsum of the foot. The anterior tarsal tunnel is a flattened space between the inferior extensor retinaculum and the fascia overlying the talus and navicular. The deep fibular nerve and its branches pass longitudinally through this fibro-osseous tunnel, deep to the tendons of the extensor hallucis longus and extensor digitorum longus. Four distinct relationships of the deep fibular nerve to the dorsalis pedis artery were determined. The dorsalis pedis neurovascular island flap contains both the dorsalis pedis artery and the deep fibular nerve. Because the design of a neurovascular free flap requires detailed knowledge of the nerve and vascular supply, the data presented here are intended to help surgeons during surgical approaches to the foot and ankle.

 
  • REFERENCES

  • 1 Standring S. Gray's Anatomy. 39th ed. New York: Churchill Livingstone; 2005. p. 1505.
  • 2 Cho BC, Lee JH, Weinzweig N, Baik BS. Use of the free innervated dorsalis pedis tendocutaneous flap in composite hand reconstruction. Ann Plast Surg 1998;40:268.
  • 3 Ohmori K, Harii K. Free dorsalis pedis sensory flap to the hand, with Microneurovascular anastomoses. Plast Reconstr Surg 1976;58:547.
  • 4 Zuhre Asli Aktan Ikiz, Hulya Ucerler, Mujde Uygur. The Clinical Importance of the Relationship between the Deep Peroneal Nerve and the Dorsalis Pedis Artery on the Dorsum of the Foot. Plast Reconstr Surg 2007;120:690.
  • 5 Dong JS, Peng YP, Zhang YX, Lim BH, Pho RW. Reverse anterior tibial artery flap for reconstruction of foot donor site. Plast Reconstr Surg 2003;112:604.
  • 6 Daniel RK, Terzis J, Midgley RD. Restoration of sensation to an anesthetic hand by a free neurovascular flap from the foot. Plast Reconstr Surg 1976;57:275.
  • 7 Strauch B, Vasconez LO. Grabb's Encyclopedia of Flaps. 1st ed. Boston: Little, Brown; 1990. p. 1797-800.
  • 8 McCraw MJ, Furlow LT. The dorsalis pedis arterialized flap. Plast Reconstr Surg 1975;55:177.
  • 9 Tang YB, Chen HC. Dorsalis pedis flap with vascularised nerve graft for simultaneous reconstruction of palm and digital nerves. Br J Plast Surg 1990;43:494.
  • 10 Chavatzas D. Revision of the incidence of congenital absence of dorsalis pedis artery by an ultrasonic technique. Anat Rec 2005;178:289-90.
  • 11 Adani, R, Marcoccio, I, and Tarallo, L. Flap coverage of the dorsum of hand associated with extensor tendons injuries: A completely vascularized single-stage reconstruction. Microsurgery.2003,23: 32.
  • 12 Neundörfer B, Seiberth R. The accessory deep peroneal nerve. J Neurol 1975;209:125-9.
  • 13 Rab M, Ebmer J, Dellon AL. Innervation of the sinus tarsi and implications for treating anterolateral ankle pain. Ann Plast Surg 2001;47:500.
  • 14 Kato T, Takagi H, Sekino S, Manabe H, Matsuno Y, Furuhashi K, et al. Dorsalis pe dis artery true aneurysm due to atherosclerosis: Case report and literature review. J Vasc Surg 2004;40:1044-8.