Variation of Superficial Palmar Arch a Case Report

Abstract

The anastomoses between radial and ulnar arteries in the palm play a significant role in diseases of the palm through collateral circulation. During routine dissection of the upper limb of a 45-year-old male cadaver, we observed the superficial palmar arch (SPA) formed exclusively by the superficial branch of the ulnar artery. The superficial palmar branch of the radial artery entered the hand above the thenar muscles and provided palmar digital branches to the radial side of the index finger and the ulnar side of the thumb, without any contribution to the SPA. However, the radial side of the thumb was supplied by a branch from the deep palmar arch. The superficial branch of the ulnar artery gave origin to three common palmar digital arteries to supply the contiguous sides of the index, middle, ring and little fingers. It also provided origin to a digital branch to the ulnar side of the little finger. Keywords: Radial artery, Superficial palmar arch, Ulnar artery I. Introduction The anastomoses between radial and ulnar arteries in the palm play a significant role in diseases of the palm through collateral circulation. During routine dissection of the MBBS students we have seen that the hand of a75 year-old male cadaver, showed variation in the completion of the superficial palmar arch (SPA) formed exclusively by the superficial branch of the ulnar artery. (The superficial arteries of the hand formed several diversified patterns that permitted into well-defined categories. About two-third of the SPA is formed by the ulnar artery alone; a further third is completed by the superficial palmar branch of the radial artery and a third either by the arteria radialis indicis or by the princeps pollicis or by the median artery. A classic type of SPA in which the superficial branch of the radial artery joins the superficial branch of the ulnar artery is found only in 34.5% of the cases. There are many reports regarding formation of SPA. In a study by Coleman et al., the complete arch was found in 78.5% of the cases and incomplete arch in the remaining 21.5%, and this formed a major underlying factor in the aetiology of digital ischaemia. Ikeda et al. conducted stereoscopic arteriography of 220 cadaver hands and reported complete SPA in 96.4% of the cases, and only 3.6% had an incomplete arch. Gellman et al. showed a complete SPA in 84.4% and Al Turk and Metcalf reported complete SPA in 84% of the cases.