Abstract
BackgroundThe superficial palmar branch of the radial artery (SPBRA) normally pierces through the thenar muscles and unites with the ulnar artery to form the superficial palmar arch. Rarely, a subcutaneous course of the SPBRA is described in which the artery lies superficial to the thenar muscles.Case reportWe report about a 17-year-old female patient with pain at the thenar eminence due to a unique course of the SPBRA. Duplex sonography and magnetic resonance angiography revealed a subcutaneous course of the artery over the thenar muscles. Arterial transposition by splitting of the abductor pollicis brevis muscle was performed. At 12-month follow-up, the patient is still free of symptoms. Duplex sonography confirmed patency of the SPBRA.ConclusionWhile a subcutaneous course of the SPBRA has been described before, we present an adolescent patient with this anatomical variation causing pain. Our specifically tailored treatment strategy consisting of arterial transposition by splitting of the abductor pollicis brevis muscle was efficient and feasible in our patient and hand surgeons should be aware of this anatomical variation.
Highlights
The superficial palmar branch of the radial artery (SPBRA) arises from the radial artery at the level of the distal forearm
Following elevation of the skin flap, the macroscopically unremarkably appearing SPBRA could be located within the subcutaneous tissue over the abductor pollicis brevis muscle (Fig. 2a)
The present report describes a case of an adolescent patient with a superficial course of the SPBRA causing pain
Summary
The superficial palmar branch of the radial artery (SPBRA) arises from the radial artery at the level of the distal forearm. A subcutaneous course of the SPBRA is described in which the artery lies superficial to the thenar muscles [4]. This rare variation does not causes clinical complications, but the present case report describes a 17-year-old female patient with repetitive pain located at the thenar eminence. Following elevation of the skin flap, the macroscopically unremarkably appearing SPBRA could be located within the subcutaneous tissue over the abductor pollicis brevis muscle (Fig. 2a). At latest follow-up, 1 year following the surgical procedure, the patient was free of symptoms with free range of motion of the thumb joint and no signs of weakness of the M. abductor pollicis brevis. Sonography showed a patent vessel beneath the abductor pollicis brevis muscle
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