Abstract
Variations of radial artery, in both its course and branching pattern in the anatomical snuffbox, are clinically significant for the plastic surgeons, cardiologists, and radiologists. Reports on its abnormal high origin and subsequent superficial course have been well documented. Herein, we report an unusual superficial branch of the radial artery given off before its entry into the palm by passing between the two heads of first dorsal interosseous. It eventually divided into princeps pollicis and radialis indicis arteries at the first web space of palm as a unique vascular variation. Apart from this, in the present case, the tendon of extensor digiti minimi and of extensor indicis divided into two parts. The split tendons of extensor digiti minimi were inserted to the dorsal digital expansion of the digitus minimus. However, lateral tendon of split extensor indicis was inserted along with the tendon of extensor digitorum to the index finger and the medial one was inserted along with the tendon of extensor digitorum to the middle finger. Unusual superficial branch of radial artery on the dorsum of the hand is vulnerable for an iatrogenic injury during surgical approaches in the region. Supplementary extensor tendons on the hand are one of the potential causes for the tenosynovitis.
Highlights
Accurate and detailed knowledge of the relationships and possible anatomical variations of the branching pattern of radial artery is vital during reparative surgery in this region
At the distal part of the forearm it winds around the lateral side of forearm after giving superficial palmar branch and enters into the anatomical snuff box, before reaching proximal end of the first interosseous space where it passes between the two heads of first dorsal interosseous muscle and between two heads of adductor pollicis to form the deep palmar arch of the palm [1]
During the dissection of the left upper limb of an adult male cadaver aged approximately 70 years, we found concurrent variations of radial artery and tendons of long extensors of the digits
Summary
Accurate and detailed knowledge of the relationships and possible anatomical variations of the branching pattern of radial artery is vital during reparative surgery in this region. At the distal part of the forearm it winds around the lateral side of forearm after giving superficial palmar branch and enters into the anatomical snuff box, before reaching proximal end of the first interosseous space where it passes between the two heads of first dorsal interosseous muscle and between two heads of adductor pollicis to form the deep palmar arch of the palm [1]. Before its entry to the palm, on the dorsum of the hand it gives slender branches to the lateral side of the dorsum of the thumb and first dorsal metacarpal artery In the palm it generally gives princeps pollicis artery and radialis indicis branches before it contributes to deep palmar arch. Anatomical knowledge on variant branching pattern of radial artery as well as abnormal tendon disposition on the dorsum of the hand is of considerable importance during several clinical approaches and therapeutic practices
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