Anatomic study of the deep plantar arch

A thorough knowledge of the topography and relations of the plantar arteries is necessary for further advances in arterial reconstruction in the foot. Such reconstruction often avoids amputation in cases of arterial trauma in industrial and automobile accidents, as well as in patients with diabetes and severe ischemia of the lower limbs. Although several studies have addressed the anatomy of the arteries of the foot, there is a shortage of recent studies on surgical vascular anatomy. The deep plantar arch was studied in 50 adult cadaveric feet. It was present in all feet and formed from the anastomosis between the deep plantar artery and the deep branch of the lateral plantar artery. The deep plantar artery was predominant in 48% of the specimens (Type I arches) and the deep branch of the lateral plantar artery in 38% (Type II) with the contribution of each being approximately equal in 14% (Type III). The location of the deep plantar arch can be estimated. The distance between the deep plantar arch and each interdigital commissure was relatively consistent between the subjects, averaging 29% of total foot length. The deep plantar arch was located in the middle third of the foot in all specimens, being in the middle II part of this third in 62%. The mean external diameter of the deep branch of lateral plantar artery was 1.7 mm +/- 0.4 mm. The mean external diameter of the deep plantar artery was also 1.7 mm +/- 0.4 mm. We observed a complete superficial plantar arch in only one specimen (2%). Our findings should assist vascular surgeons in estimating the location of the deep plantar arch from the patient's foot length and in providing other data.