Summary
Three-dimensional arteriography was used to analyse the arterial supply of the great and second toes of 100 cadaveric feet down to the microsurgical level. This information will aid in successful composite tissue transfers of these toes to the hand. The arterial blood supply of the great toe came principally from the first dorsal metatarsal a. (78%) and the first plantar metatarsal a. (22%), and secondarily from the medial tarsal aa. and the three terminal branches of the medial plantar a. For the second toe, the first dorsal metatarsal a. (78%) and the first plantar metatarsal a. (22%) supplied blood from the medial side, and the second dorsal metatarsal a. (78%) and the second plantar metatarsal a. (22%) supplied blood from the lateral side. Seven arterial patterns were found in the interdigital web space. The socalled general pattern was seen in the first web space in 65% of the feet examined. In the second web space it was found in 85%. The first intermetatarsal space sometimes contained a large artery arising directly from the dorsalis pedis or first proximal perforating a. as well as the first dorsal and first plantar metatarsal arteries. In this space, arterial patterns were classified into 4 types and 9 subtypes based on the origins and proximal courses of these arteries. The so-called standard pattern was found in only 19% of the feet, while an arterial pattern with a common proximal trunk on the plantar side for the first dorsal and first plantar metatarsal aa. was found most frequently (46%). In the second intermetatarsal space the second dorsal metatarsal a. was usually located on the dorsum.
Résumé
L'artériographie en trois dimensions a été utilisée pour analyser la vascularisation artérielle de l'hallux et du deuxième orteil de cent pieds de cadavres jusqu'au niveau microchirurgical. Ces renseignements aideront au succès des transferts de tissus composites de ces orteils vers la main. La vascularisation artérielle de l'hallux vient principalement de la première artère métatarsienne dorsale (78 %) et de la première artère métatarsienne plantaire (22 %) et secondairement des artères tarsiennes médiales et des trois branches terminales de l'artère plantaire médiale. Pour le deuxième orteil, la première artère métatarsienne dorsale (78 %) et la première artère métatarsienne plantaire (22 %) vascularisent le versant médial, la deuxième artère métatarsienne dorsale (78 %) et la deuxième artère métatarsienne plantaire (22 %) vascularisent le versant latéral. Sept dispositions artérielles ont été trouvées dans la commissure interdigitale. Une disposition dénommée “commune” a été vue dans la premiere commissure sur 65 % des pieds examinés, dans la deuxième commissure dans 85 % des cas. Le premier espace intermétatarsien contient parfois une volumineuse artère, naissant directement de l'artère dorsale du pied ou de la première artère perforante proximale, mais aussi des premières artères métatarsiennes dorsale ou plantaire. Dans cet espace, les dispositions artérielles sont classées en 4 types et 9 sous-types, basés sur l'origine et le trajet proximal de ces artères. La disposition standard a été trouvée seulement sur 19 % des pieds, alors qu'une disposition comprenant un tronc proximal commun situé sur le versant plantaire, fournissant les premières artères métatarsiennes dorsale et plantaire, a été trouvée plus fréquemment (46 %). Dans le deuxième espace intermétatarsien, la deuxième artère métatarsienne dorsale était habituellement située sur le versant dorsal.
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Hamada, N., Ikuta, Y. & Ikeda, A. Arteries to the great and second toes based on three-dimensional analysis of 100 cadaveric feet. Surg Radiol Anat 15, 187–192 (1993). https://doi.org/10.1007/BF01627702
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DOI: https://doi.org/10.1007/BF01627702