MORPHOMETRIC ANALYSIS OF LATERAL TARSAL ARTERY AND ITS SURGICAL IMPORTANCE

Address for Correspondence: Dr. Arun Chepte, Department of Anatomy, Rural Medical College, Pravara Institute of Medical Sciences, (Deemed University), Loni Tal, Rahata Dist, Ahmednagar (MS), India. E-Mail: drarunchepte@gmail.com The present study was carried out on 60 cadaveric lower limbs in Dept. of Anatomy, TNMC, Mumbai. Lateral tarsal artery (LTA) was studied with regard to origin, course, branches and its length & external diameter were noted. LTA was present in 59 cases. Dorsal metatarsal arteries in 7 cases arose from LTA. The mean length was 34.16 ± 0.22 mm. The mean external diameter at its origin was 2.09 ± 0.33 mm. Lateral tarsal artery is useful as an artery flap to repair web contractures and plays a great role in forefoot defect surgeries.

Lateral tarsal artery is a branch of dorsalis pedis artery.It supplies dorsum of foot.It ends by supplying overlying muscles and underlying metatarsals [1].It's a significant vascular channel of foot.Forefoot is portion of the foot distal to the tarsometatasal joint and is the major weight bearing portion in standing.A lateral tarsal (LT) flap is a reasonable option for treating traumatic forefoot skin and soft tissue defects [2].Bypass to tarsal arteries plays important role in limb salvage of ischemic limbs in diabetic patients.Knowledge of this artery is helpful in limb amputation surgeries [3].limbs of unknown sex & age from the department of Anatomy and dorsum of foot was dissected.The long extensor tendons were severed.Dorsalis pedis artery identified, its branches were traced (Fig. 1).Lateral tarsal artery deep to tendons was identified and traced, and its length & external diameter were measured.Length of the lateral tarsal artery: It was measured as the distance between its origin i.e. point of origin from DPA to its termination i.e. when it joins any other artery to form anastomosis with the help of calibrated digital vernier caliper.(Fig.2) External diameter of the lateral tarsal artery: It was measured at its origin from dorsalis pedis artery with the help of calibrated digital vernier caliper.(Fig. 3)

MATERIALS AND METHODS
The study was conducted in the department of anatomy in TNMC & BYL Nair Ch.Hospital, Mumbai.The study was carried out on 60 lower         4).5)

Fig. 3 :
Fig. 3: Measurement of the external diameter of lateral tarsal artery at the origin.

(
LTA -Lateral Tarsal Artery, E.D -External Diameter) Lateral tarsal artery arises from dorsalis pedis artery, supplies tarsals and metatarsals.It also gives some muscular branches to overlying short muscles of dorsum of foot.It ends by anastomosing with small branches of dorsalis pedis artery.In the present study, LTA was present in 59 cases (98.33%).It was absent in 1(1.66%) case.(Fig 4) Normally LTA does not give Dorsal metatarsal arteries(DMA)1 however in the present study in 7 cases (11.66%)LTA gave DMA's.(Fig. 5) Keely cassidy & MA Khan (2011)[4] in a study of 18 feet noted the lateral tarsal artery present in 94% of the cadaveric feet and absent in 6 %.Measurement of length of the lateral tarsal artery :( In mm) In the present study the length of the lateral tarsal artery ranged from 12.68mm to 57.5 mm with a mean of 34.16±8.22mm.EM El-Saeed et al. (2008)[5] found the length of the lateral tarsal artery in the range 18mm to 37 mm with a mean of 27± 5.7mm (Table

Findings
of the present study for length of the LTA were higher than EM El-Saeed et al. (2008) [5].This can be attributed to racial, ethnic and population diversity.Measurement of external diameter of the lateral tarsal artery : (In mm) In present study the external diameter of lateral tarsal artery ranged from 1.11 to 2.93 mm with a mean of 2.09±0.33mm.Findings of the present study for external diameter of the LTA were closely related with EM El-Saeed et al. (2008) [5].(Table

Table 1 :
Descriptive statistics of measurements of the lateral tarsal artery: ).It was absent in 1 (1.66%) case.Normally LTA does not give dorsal metatarsal arteries (DMA)1 however in the study in 7 cases (11.66%)LTA gave DMA's.The mean length is 34.16 ± 0.22 mm.It ranges between 12.68 mm -57.5 mm.The mean external diameter of LTA at its origin is 2.09 ± 0.33 mm.It ranges between 1.11 mm -2.93 mm.(Table1) Maximum number (76.27%) of lower limbs were having average length of LTA in the range of 25.48 mm -44.69 mm and minimum number (13.55%) of lower limbs were having the length less than 25.48 mm and 10.16% had length more than 44.69 mm.(Table2) Maximum number (88.13%) of lower limbs were having the external diameter of LTA at its origin in the range of 1.63 mm -2.67 mm and 8.47% of lower limbs were having E.D of less than 1.63 mm and 3.38% had E.D more than 2.67 mm.(Table3)OBSERVATIONS AND RESULTS(LTA -Lateral Tarsal Artery, E.D -External Diameter)

Table 2 :
Distribution of study group according to length of LTA.

Table 3 :
Distribution of study group according to external diameter of lateral tarsal artery.

Table 4 :
Comparison of the length of the lateral tarsal artery with the previous studies.

Table 5 :
Comparison of the external diameter of the lateral tarsal artery with the previous studies: