title: Anatomical classification of the first dorsal metatarsal artery and its clinical application.
abstract: BACKGROUND
  Vascularized tissue transfer pedicled with the first dorsal metatarsal artery is commonly used in the microsurgical reconstruction of tissue defect. However, there are great anatomical variations of the artery. In this study, the authors classified the artery based on its origin (from where it arises), branches, and course. The significance of this classification system related to harvesting a first dorsal metatarsal artery-based tissue transfer is also discussed.
  
  
  METHODS
  Fresh tissue dissection (n = 48) and cast specimens (n = 30) were studied. Three-dimensional reconstruction (n = 5) was performed based on the computed tomography angiogram of the adult feet. Ultrasound color Doppler imaging was performed on 340 feet. The anatomy of first dorsal metatarsal artery was also studied in patients (n = 148) who had surgery on the first web space.
  
  
  RESULTS
  The intramuscular type of the artery described by Gilbert was not found in any of the study specimens. The most common type was found in the space between the dorsal interosseous muscle and the first metatarsal. The authors thus propose a new classification system for the first dorsal metatarsal artery: the arises (origin), branch, and course (ABC) classification system.
  
  
  CONCLUSIONS
  The arises (origin), branch, and course classification system can help a surgeon to better understand the anatomical variations of the first dorsal metatarsal artery and harvest vascularized tissues based on the artery.
authors.affiliation: JJinan, Shandong, and Guangzhou, Guangdong, People's Republic of China; and Tucson, Ariz. From the Department of Hand and Foot Surgery, Provincial Hospital Affiliated to Shandong University; the Department of Anatomy, School of Basic Medical Science, Southern Medical University; and the Division of Reconstructive and Plastic Surgery, Department of Surgery, University of Arizona.
authors.forename: Zhidian
authors.initials: Z
authors.lastname: Hou
authors.forename: Jiyao
authors.initials: J
authors.lastname: Zou
authors.forename: Zengtao
authors.initials: Z
authors.lastname: Wang
authors.forename: Shizhen
authors.initials: S
authors.lastname: Zhong
mesh_terms: D000293:Adolescent; D000328:Adult; D001158:Arteries / Q000033:anatomy & histology* / Q000601:surgery; D002102:Cadaver; D004210:Dissection; D005260:Female; D064368:Healthy Volunteers; D006801:Humans; D008297:Male; D008684:Metatarsus / Q000098:blood supply* / Q000000981:diagnostic imaging / Q000601:surgery*; D008866:Microsurgery / Q000379:methods; D008875:Middle Aged; D018482:Muscle, Skeletal / Q000098:blood supply* / Q000000981:diagnostic imaging / Q000601:surgery*; D019651:Plastic Surgery Procedures / Q000379:methods*; D020858:Tissue and Organ Harvesting / Q000379:methods; D014034:Toes / Q000098:blood supply / Q000000981:diagnostic imaging / Q000601:surgery; D018608:Ultrasonography, Doppler; D055815:Young Adult