Relationship of the Dorsalis Pedis Artery to the Tarsal Navicular

When undertaking surgical maneuvers about the midfoot, caution must be used to avoid injury to the dorsalis pedis artery, which courses along the dorsum of the foot on the dorsolateral aspect of the tarsal navicular. In an effort to better understand the relationship of the course of the dorsalis pedis artery relative to the tarsal navicular, 128 embalmed feet (31 [48.4%] female and 33 [51.6%] male cadavers aged 15 to 91 years) were measured. The dorsalis pedis artery was dissected from its origin to its termination (i.e., the first dorsal metatarsal artery and the deep plantar perforating artery), and the distance from the medial cortex of the navicular tuberosity to the medial margin of the artery and the location of the artery as a percentage of the medial-to-lateral width of the navicular were measured. In the male cadaver specimens, the distance from the navicular tuberosity to the dorsalis pedis was 23.75 +/- 3.1 mm, the width of the navicular was 37.41 +/- 5.0 mm, and the location of the artery as a percentage of the width of the navicular was 64.34% +/- 13.1%. In the female cadaver specimens, the distance from the navicular tuberosity to the dorsalis pedis was 22.81 +/- 5.5 mm, the width of the navicular was 36.11 +/- 4.0 mm, and the location of the artery as a percentage of the width of the navicular was 63.29% +/- 9.9%. For the right foot specimens, the distance from the navicular tuberosity to the dorsalis pedis artery was 20.29 +/- 3.3 mm, and the width of the navicular was 37.21 +/- 4.4 mm. For the left foot specimens, the distance from the navicular tuberosity to the dorsalis pedis was 21.40 +/- 2.5 mm, and the width of the navicular was 35.92 +/- 4.4 mm. The statistical comparisons between the males and females showed no statistically significant differences. In contrast, those between the right and left feet showed significant differences in the distance from the navicular tuberosity to the dorsalis pedis artery and the location of the dorsalis pedis artery as a percentage of the width of the navicular. Knowledge of these distances and the location of the dorsalis pedis artery relative to the width of the tarsal navicular should aid surgeons in preparation for, and during, dissection of the midfoot. (C) 2015 by the American College of Foot and Ankle Surgeons. All rights reserved.