Abstract:

Objective　To provide anatomical basis of the perforator-based intermediate dorsal pedal neurocutaneous vascular flap for repair of soft tissue defects of the forefoot.　Methods　The following contents were investigated in 30 adult feet specimens perfused with red latex. ①The course and distribution of the intermediate dorsal cutaneous nerve. ②The 3rd dorsal perforator of the plantar arch and its anastomosis with the intermediate dorsal cutaneous neural nutrient vessels. Simulated operation was performed on another fresh specimen.　Results　①The intermediate dorsal cutaneous nerve mainly arose from the lateral branch of the superficial peroneal nerve. Crossing the surface of the cruciate ligament, it proceeded forward to the proximal part of the 4th metatarsal gap and then divided into the 3rd and 4th dorsal metatarsal branches, which were distributed in part of dorsal pedal and digital skin. ②The intermediate dorsal cutaneous neural nutrient vessels was multiple in segments and sources, which was closely related to operation type. The 3rd dorsal perforator of plantar arch had a relatively constant position located at the proximal part of the 4th intermetatarsal space. It gave out numerous tiny vessels which anastomosed closely with branches of intermediate dorsal cutaneous neural or paraneural nutrient vessel chain.　 Conclusion　The intermediate dorsal pedal neurocutaneous vascular flap based on the 3rd dorsal perforator of plantar arch could be transferred to repair the soft tissue defects of forefoot.

Key words: The 3rd dorsal perforator of plantar arch, Intermediate dorsal cutaneous nerve, Neurocutaneous vascular flap