Relationship between the deep peroneal nerve and dorsalis pedis artery in the foot: a cadaveric study.

The aim of our work was to study the relationship between deep peroneal nerve (DPN) and dorsalis pedis artery (DPA) so that the frequency of these variations can be kept in mind by the angiographers and surgeons to ensure safe surgical approach during flap surgery. Ninety-two legs in 46 cadavers were dissected to study the relationship between DPN and DPA on the dorsum of the foot. The relationship of neurovascular bundle of the dorsum of the foot was classified into four types. Type I: division of the DPN distal to the midpoint between the two malleoli (observed in 26 limbs). In Type II, the division of the DPN was midway between the two malleoli (seen in 20 limbs). Both Type I and II are further divided into two subtypes (a and b) depending upon the crossing pattern of terminal branches of the DPN over DPA. In Type III, multiple branches of DPN were noted in two limbs. In Type IV, the looping pattern of DPN around the DPA was considered and was seen in eight limbs. Awareness of possible variations in the relationship of the DPA to DPN on the dorsum of the foot is important for vascular and reconstructive surgeons. Because it might help in decreasing confusion when considering treatment options like microvascular anastomosis in reconstruction of the leg. (c) 2008 Wiley-Liss, Inc.