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Arcuate Artery of the Foot

arteria arcuata pedis

The arcuate artery of the foot is an inconstant branch of the dorsalis pedis artery arising at the level of the tarsometatarsal joints and running laterally across the dorsal foot to give rise to the second, third, and fourth dorsal metatarsal arteries. It forms an arch across the dorsal metatarsal bases. The first dorsal metatarsal artery usually arises directly from the dorsalis pedis.

Region: Foot & Ankle

Clinical Relevance

Clinical Notes

The arcuate artery and the dorsal metatarsal arteries it supplies are relevant in forefoot reconstructive surgery and in planning of dorsal foot flaps. The dorsal metatarsal arteries are the pedicles for the dorsal metatarsal artery perforator flap used for adjacent web space and toe reconstruction. In Lisfranc injury repair with open reduction, the arcuate artery territory at the TMT joint level may be compromised by the injury or by excessive traction, risking dorsal forefoot ischaemia. The arcuate artery is absent in approximately 30% of individuals, with the second and third dorsal metatarsal arteries arising directly from the dorsalis pedis in these cases.

Pathology

Common Injuries & Conditions

Arcuate Artery Injury in Lisfranc Reconstruction

Open reduction of Lisfranc fracture-dislocation risks the arcuate artery crossing the dorsal TMT joints at the injury level; dorsal forefoot ischaemia from arcuate artery compromise presents as forefoot pallor and skin blistering, requiring vascular assessment and consideration of flap coverage if non-viable skin develops.