The Vascular Pattern of the Anterior Muscles of the Forearm in Adults in Relation to Volkmann’s Ischaemic Contracture

Abstract

There exists already a copious literature on the blood supply of various organs and tissues, yet only a few papers are dedicated to the description of vascular patterns in human skeletal muscles. Wollenberg'2 and Campbell and Pennefather5 drew attention to the lack of anastomoses between adjacent muscle groups in the lower limbs, and they stressed the fact that certain muscles were penetrated by a number of vessels, whereas others received their supply from a single artery. Blomfield' recognized five main types of vessel distribution in muscles of the lower extremities of man. He related the vulnerability or otherwise of some muscles to ischaemia to several vascular factors, among them the number of nutrient arteries derived from independent sources and the particular intramuscular arrangement, the longitudinal disposition being more susceptible to injury than the pattern of anastomotic loops. Edwards7 classified the muscles of the lower limbs of man into: (a) Those receiving vessels from several sources; (b) those possessing a series of arteries arising from a long segment of one major trunk; (c) those supplied by one or by only a few branches, taking origin from a localized segment of one arterial trunk. In explaining the liah ity of particular muscles to ischaemia, he ins ed that the circulation in a muscle is an isolated unit, the arteries having no substantial connections with the vessels of the neighbouring structures. An intramuscular network of anastomoses between branches of the arteries does exist, but as Le £Gros Clark and Blomfield8 have shown, it is often of a pattern which does not prevent ischaemia after occlusion. Brash3 claimed that in most of the muscles there are subsidiary arteries, usually placed at