Depth of the Dorsalis Pedis Artery Distal to the First and Second Tarsometatarsal Joints: A Cadaveric Anatomical Study.

Background: Surgical procedures involving the region between the first and second metatarsals distal to the tarsometatarsal (TMT) joints are common. However, detailed quantitative information regarding the depth of this arterial axis, encompassing the dorsalis pedis artery proximal to the branching point and the first dorsal metatarsal artery distally, remains limited. This study aimed to characterize the depth of the dorsalis pedis artery distal to the first and second TMT joints. Methods: Nineteen feet from 12 cadavers were analyzed. The first and second metatarsals were marked at 10-mm intervals distal to each TMT joint. The arterial depth at each point was expressed as a percentage of total metatarsal height, measured from the dorsal cortical surface (0%) toward the plantar cortex. Results: The deep plantar branch originated 11.0 ± 3.5 mm distal to the first TMT joint and 22.3 ± 4.5 mm distal to the second TMT joint. At 30 mm distal to the TMT joints, the arterial depth corresponded to 52% ± 18% of the metatarsal height in the first metatarsal and 67% ± 19% in the second metatarsal. Mean metatarsal lengths were 61.2 ± 3.1 mm (first) and 74.5 ± 3.7 mm (second). Conclusions: Distal to the TMT joints, the dorsalis pedis artery initially courses plantarly and gradually returns dorsally. These findings provide quantitative anatomical information regarding the trajectory of the dorsalis pedis artery in the intermetatarsal region distal to the TMT joints. Awareness of this depth trajectory may help surgeons minimize unnecessary arterial contact, particularly during screw placement across the intermetatarsal space. Level of evidence: Level V, cadaveric anatomical study.