Cadaveric Study of Topographical Location and Arterial Diameter of Superficial Palmar Arch with its Clinical Implication

Abstract

Background: During the surgical exposure of carpal tunnel, it is possible to injure neurovascular structures, especially the superficial palmar arch (SPA) due to its proximity to the flexor retinaculum. Hence, the topographical location of SPA is necessary to avoid iatrogenic injuries. Size of the vessels forming SPA is important to carry out new procedures in the microsurgical techniques in reconstructive surgeries. Materials and Methods: The present study was conducted on 40 cadaveric hands obtained from AJ Institute of Medical science, Mangalore. The distance between the SPA and distal wrist crease (DWC) and Kaplan's cardinal line (KCL) were measured. Diameters of arteries which are mainly contributing in the formation of SPA and its branches were measured with a digital caliper, and mean and standard deviation were calculated. Results: The distance of SPA, from DWC was 44.22 ± 4.98 mm and from KCL along the lateral and medial border of ring fingers was 8.32 ± 1.01 mm and 9.54 ± 0.95 mm, respectively. The average diameter of the ulnar artery was 2.84 mm; radial artery was 2.79 mm; the superficial palmar branch of the radial artery, princeps pollicis artery, and the median artery was 1.5 mm, 1.24 mm, and 2.025 mm, respectively. Conclusion: The results of the present study on the location of the SPA as well as arterial diameters will be of great help for the surgeons and radiologists. Advances in reconstructive surgeries of the hand, especially microsurgeries has entailed a better understanding of arterial variations, in-depth knowledge of which is necessary for the positive outcome of surgical procedures.