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Vascular anatomy of the first metatarsal bone and surgical implications according to the severity of hallux valgus deformity: A cadaveric study
Authors:Sérgio Soares  Tiago Mota Gomes  Gustavo Campos  Filipe Medeiros  João Bragança  Xavier Martin Oliva
Affiliation:1. Department of Orthopaedics, Hôpital du Valais, Martigny, Switzerland;2. Foot and Ankle Unit, Department of Anatomy and Human Embryology, Faculty of Medicine, University of Barcelona, Barcelona, Spain;3. Department of Orthopaedics, Hospital Roosevelt, Guatemala City, Guatemala;4. Department of Orthopedics, Centro Hospitalar Universitário do Algarve, Faro, Portugal;5. Department of Orthopaedics, Hôpital Fribourgeois, Fribourg, Switzerland;6. Department of Orthopaedics, Clinica del Remei, Barcelona, Spain
Abstract:
BackgroundVascular injury after hallux valgus surgery is a rare condition but serious complications can ensue.MethodsWe performed an anatomical study using 26 cadaveric lower extremities. We enhanced first metatarsal bone’s (FMB) vascularization by injecting latex. Each specimen was classified according to the severity of hallux valgus deformity (HVD). Then we measured two distances: one between the first tarsometatarsal joint (FTMJ) to the first dorsal branch’s origin, the other between the first metatarsophalangeal joint (MTP) to the dorsal plexus’s origin.ResultsThe distance between the FTMJ and the first dorsal branch to the FMB ranges from 10 mm in normal feet to 15 mm in severe deformed feet. The distance between the MTP and the dorsal plexus’ origin ranges from 20 mm in normal feet to 25 mm in severe deformed feet.ConclusionsUnderstanding the foot’s vascular anatomy has allowed us to adapt surgical landmarks to the severity of the HVD and to avoid post-operative complications.
Keywords:Vascularisation  Hallux valgus  Osteotomy  Joint fusion  Non-union  Avascular necrosis
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