Abstract
Objectives The aim of this study was to define landmarks of the intermetatarsal channel of the
dorsal pedal artery and to assess whether damage to the dorsal pedal artery during
metatarsal screw placement in dogs undergoing pan- and partial-tarsal arthrodesis
(PanTA/ParTA) could be a mechanism in the development of plantar necrosis.
Study Design This study was divided in to two parts: (1) ex-vivo anatomical study: 19 canine cadavers,
(2) retrospective clinical study: 39 dogs. Cadaveric dissection documented the mean
intermetatarsal channel position. Metatarsal screw position was evaluated on postoperative
radiographs of dogs after PanTA or ParTA. Screw position, arthrodesis type and surgical
approach were assessed for their impact on complications, including plantar necrosis.
Results The mean proximal and distal extent of the intermetatarsal channel lies between 4.3% ± 1.9
and 22.8% ± 2.9 the length of metatarsal III (MTIII) respectively. The intermetatarsal
channel lies within the most proximal 25% of MTIII in 95% of cases. At least one screw
risked damaging the mean intermetatarsal channel position in 92% of dogs; 8% of these
dogs went on to develop plantar necrosis. The mean screw position did not differ between
ParTA cases with or without plantar necrosis (p > 0.05).
Conclusion Violation of the intermetatarsal channel is possible during metatarsal screw placement.
Care should be taken when placing screws in the proximal 25% of the metatarsals, specifically
avoiding exiting dorsally between MTII and MTIII and across the distal region of the
intermetatarsal channel, where the perforating metatarsal artery passes interosseously,
as damage may contribute to the aetiology of plantar necrosis.
Keywords
plantar necrosis - arthrodesis - perforating metatarsal artery - intermetatarsal channel
- pantarsal
