Arcus Venosus Dorsalis Pedis: Morphological Considerations for Use in Superficial Palmar Arch Reconstruction

作者：Lee John J; Ruta David J; Lien John R; Brunfeldt Alex; Lawton Jeffrey N; Ozer Kagan^*

来源：Journal of Hand Surgery-American Volume, 2014, 39(11): 2243-2245.

DOI：10.1016/j.jhsa.2014.08.020

• Arcus venosus dorsalis pedis
• dorsal foot vein
• palmar arch reconstruction
• saphenous vein
• vein diameter

Purpose To report the branching patterns, vessel diameters, and location of the valves in the arcus venosus dorsalis pedis (AVDP) as a graft option for use in superficial palmar arch reconstruction after mutilating hand injuries.
Methods We dissected 10 cadaveric feet and measured vessel diameters, recorded number of branches, and located valves within the tibial, middle, and fibular thirds of the system. We used retrograde india ink injection to locate valves.
Results The AVDP branching pattern was grossly different from side to side in the 4 cadavers with bilateral feet available. Mean flat diameters were 4.7, 2.9, and 2.1 mm in the tibial, middle, and fibular thirds of the arch, respectively. There was a mean of 1.7 valves (range, 1-4 valves) in the tibial third, 1.5 valves (range 0-4 valves) in the middle third, and 0 valves in the fibular third. There was an average of 3.4 branches off the middle third with a mean branch diameter of 2.1 mm. In 65% of these branches, valves were within 1 cm distal to the main arch. The direction of flow within the middle third was from fibular to tibial.
Conclusions Valves were commonly found within the middle and tibial thirds of the AVDP and within branches just distal to bifurcations. By contrast, the fibular third of the AVDP contained no valves. Valvular anatomy suggests that the direction of flow within the middle third was from fibular to tibial direction.

• 出版日期2014-11