Abstract
The vascular anatomy of the hand is a complex and challenging area and has been the subject of many studies. Knowledge of the vascular patterns and diameters of the hand gained more importance with improvements in microsurgical techniques in reconstructive hand surgery. We evaluated 50 hands (26 left, 24 right) of 26 formalin preserved cadavers to determine the superficial palmar arch, its branches and contributing vessels with special attention to the diameters. The symmetry of the types was also evaluated in detail for the first time in the literature. Measurements were made with the help of a digital caliper. The diameters of the ulnar, radial and median arteries were taken at the level of the wrist while the common palmar digital arteries, hypothenar branches and the superficial palmar branch of the radial artery were measured at their origin. Two types of superficial palmar arch were found and defined as complete (43/50 hands) and incomplete arches (7/50 hands). The complete arches were divided into four subgroups and incomplete arches into three subgroups. Most cases were found at the complete AI group (17 hands). Comparison of the arterial diameters showed the ulnar artery was the dominant vessel of the palm. The diameters of the common palmar digital arteries were not different with regard to complete or incomplete arches and between both sides. It looks safe to sacrifice one of the radial or ulnar arteries in some arterial interventions including radial artery cannulation, radial forearm flap and radial or ulnar artery harvesting for bypass grafting if the arch is complete. But we still recommend the noninvasive tests like modified Allen test or Doppler ultrasonography, before performing an invasive arterial intervention. We propose the radiologists to incorporate the median artery into the Doppler dynamic test in particular the existence or the absence of anastomoses between radial and ulnar arteries.
Similar content being viewed by others
References
Adachi B (1928) Das Arteriensystem der Japaner. Kyoto, vol. I:365–366, 389
Agur AM, Lee MJ (1999) Grant’s atlas of anatomy. 10th edn. Lippincott, Williams & Wilkins, Philadelphia
Coleman SS, Anson BJ (1961) Arterial patterns in the hand based upon a study of 650 specimens. Surg Gynecol Obstet 113:409–442
Dubreuil-Chambardel L (1926) Variations des artères du membre supérieur. Masson, Paris, pp 145–150, 228–235
Dujarier C (1905) Anatomie des membres. Dissection-anatomie topographique. G Steinheil, Paris, pp 83–93
Edwards EA (1960) Organization of the small arteries of the hand and digits. Am J Surg 99(6):837–846
Fazan VPS, Borges CT, Silva JH, Caetano AG, Filho OAR (2004) Superficial palmar arch: an arterial diameter study. J Anat 204(4):307–311
Gellman H, Botte MJ, Shankwiler J, Gelberman RH (2001) Arterial patterns of the deep and superficial palmar arches. Clin Orthop 383:41–46
Ikeda A, Ugawa A, Kazihara Y, Hamada N (1988) Arterial pattern in the hand on a three-dimensional analysis of 220 cadaver hands. J Hand Surg 13(4):501–509
Jaschtschinski SN (1897). Morphologie und Topographie des Arcus volaris sublimes und profundus des Menschen. Anat Heft 7:161–188
Jelicic N, Gajisin S, Zbrodowski A (1988) Arcus palmaris superficialis. Acta Anat 132(3):187–190
Kenesi C, Alexandre JH, Aaron C (1967) Les artères de la main. Arch Anat Path 15(2):99–102
Moore KL, Dalley AF (1999) Clinically oriented anatomy. 4th edn. Lippincott, Williams & Wilkins, Philadelphia
Omokawa S, Tanaka Y, Ryu J, Clovis N (2001) Anatomical consideration of reverse-flow island flap transfers from the midpalm for finger reconstruction. Plast Reconstr Surg 108(7):2020–2025
Paolo P, Serricchio M, Flore R, Manasse E, Favuzzi A, Posatti GF (1996) Safe removal of the radial artery for myocardial revascularization: a Doppler study to prevent ischemic complications to the hand. J Thorac Cardiovasc Surg 112(3):737–744
Poirier P, Charpy A (1901) Traité d’anatomie humaine. Vol 2. Masson, Paris, pp 746–750
Ruengsakulrach P, Eizenberg N, Fahrer C, Fahrer M, Buxton BF (2001) Surgical implications of variations in hand collateral circulation: anatomy revisited. J Thorac Cardiovasc Surg 122(4):682–686
Ruengsakulrach P, Brooks M, Hare DL, Gordon I, Buxton BF. (2001) Preoperative assessment of hand circulation by means of Doppler ultrasonography and the modified Allen test. J Thorac Cardiovasc Surg 121(3):526–531
Williams PL, Bannister LH, Berrymm et al (1995) Gray’s Anatomy. 38th edn. Churchill Livingstone, New York
Author information
Authors and Affiliations
Corresponding author
Additional information
This study was accepted as an oral presentation in the “IX National Congress of Anatomists, 7–10 September 2005, Kusadasi, Turkey”
Rights and permissions
About this article
Cite this article
Bilge, O., Pinar, Y., Özer, M.A. et al. A morphometric study on the superficial palmar arch of the hand. Surg Radiol Anat 28, 343–350 (2006). https://doi.org/10.1007/s00276-006-0109-9
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00276-006-0109-9