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. 2023 May;57(3):92-98.
doi: 10.5152/j.aott.2023.22158.

Anatomical study of the distal course of the posterior tibial artery: A cadaver study

Burak Karip  1 , Ahmet Ertaş  2 , Hüseyin Avni Balcıoğlu  1
Affiliations

Anatomical study of the distal course of the posterior tibial artery: A cadaver study

Burak Karip et al. Acta Orthop Traumatol Turc. 2023 May.

Abstract

Objective: This study aimed to describe the course, branches, and variances of the posterior tibial artery, which provides the arterial supply of the plantar surface of the foot, starting from the tarsal tunnel level to provide descriptive information for all surgical interventions, diagnostic radiological procedures, and promising endovascular therapies in the tarsal region.

Methods: In this study, a dissection of 48 feet was performed on 25 formalin-fixed cadavers (19 males and 6 females). Surgical instruments and a digital caliper were used for dissection and measurements, and the critical structures were recorded by a Canon 250D camera to be illustrated later.

Results: All parameters were significantly longer in male cadavers compared to females. According to the correlation analysis, while there was a significant and robust correlation between the axial line and pternion-deep plantar arch (R=.830, P .05), a moderate correlation was found between the axial line and sphyrion-bifurcation (R=.575; P < .05), axial line and deep plantar arch-2nd interdigital commissure (R=.457; P < .05), and sphyrion-bifurcation and pternion-deep plantar arch (R=.480; P < .05). Variation in any branch of the posterior tibial artery was observed in 27 of the 48 studied sides.

Conclusion: In our study, the branching and variability of posterior tibial artery on the plantar surface of the foot were described in detail with the determined parameters. In conditions that cause tissue and function loss and require reconstruction, such as diabetes mellitus and atherosclerosis, the most critical factor in increasing treatment success is a better understanding of the region's anatomy.

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Figures

Figure 1.
Figure 1.
Multiple variations in DPA, MPA, and LPA. Arrowhead: LPA; thick arrow: MPA; thin arrow: DPA. AHM, abductor hallucis muscle; DPA, deep plantar arch; FDLM, flexor digitorum longus muscle; LPA, lateral plantar artery; MPA, medial plantar artery.
Figure 2.
Figure 2.
Superficial branch of MPA without a deep branch of MPA. Arrowheads: superficial artery. LPA, lateral plantar artery; MPA, medial plantar artery; PTA, posterior plantar artery.
Figure 3.
Figure 3.
The deep branch courses to the navicular bone. Arrow: the navicular bone. Asterisk: deep branch of MPA. LPA, lateral plantar artery; MPA, medial plantar artery; PTA, posterior plantar artery.
Figure 4.
Figure 4.
Arrow: fascial connections between AHM and PF, asterisk: a kind of tunnel. AHM, abductor hallucis muscle; PF, plantar fascia.
See this image and copyright information in PMC

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