IJAR.2020.231
Type of Article: Original Research
Volume 8; Issue 4.2 (December 2020)
Page No.: 7817-7822
DOI: https://dx.doi.org/10.16965/ijar.2020.231
VARIATIONS OF THE SUPERFICIAL PALMAR ARCH: A CLINICO-ANATOMICAL CONSIDERATION
Pooja Dawani 1, Anita Mahajan *2, Sabita Mishra 3, Neelam Vasudeva 4.
1 Senior Resident of Anatomy, Maulana Azad Medical College, New Delhi, India.
*2 Director Professor of Anatomy, Maulana Azad Medical College, New Delhi, India.
3 Director Professor and Head of Anatomy, Maulana Azad Medical College, New Delhi, India.
4 Ex. Director Professor of Anatomy, Maulana Azad Medical College, New Delhi, India.
Address for Correspondence: Dr Anita Mahajan, Director Professor of Anatomy, Maulana Azad Medical College, New Delhi, India. E-Mail: anitamahajan24@gmail.com
ABSTRACT
Introduction: The superficial palmar arch plays a vital role in the blood supply to the hand. The knowledge of variations in the pattern of superficial palmar arch and its branches, and caliber of these arteries, has become more important for surgeons in reconstructive hand surgeries and radial artery harvesting for myocardial revascularization. The aim of this study was to observe the variations and measure the diameter of contributing arteries of the arches.
Materials and methods: In the present study, thirty hands from formalin fixed adult human cadavers were dissected. Normal pattern as well as variations in the arteries contributing to the arch, completeness of arch, and the branching pattern were observed and noted. With the help of a digital caliper, the diameters of ulnar and radial arteries and median artery were taken at the level of the wrist and statistical analysis of the results was done.
Results: It was observed that in 96.7 % cases, the superficial palmar arch was complete where there was anastomosis between the arteries forming the arch. In 3.3% cases, the arch was incomplete. The complete arch was divided into radioulnar (36.7%), ulnar (56.7%) and medianoulnar (3.3%) types. The diameter of superficial palmar branch of radial artery was found to be significantly less than the diameter of ulnar artery. (p=0.003).
Conclusion: The data obtained on variations and morphometry of superficial palmar arches will certainly be useful in planning and choosing appropriate and safe surgical procedures to prevent inadvertent outcome.
KEY WORDS: Palmar arch, blood supply, Hand, radial artery, myocardial revascularization.
REFERENCES
[1]. Nunoo-Mensah J. An unexpected complication after harvesting of the radial artery for coronary artery bypass grafting. Ann Thoracic Surg. 1998;66(3):929-31.
https://doi.org/10.1016/S0003-4975(98)00559-1
[2]. Singer E. Embryological pattern persisting in the arteries of the arm. Anat Rec. 1933;7:263-82.
https://doi.org/10.1002/ar.1090550407
[3]. Moore KL, Persaud TVN. Blood supply to the limbs. In: Before We Are Born – The Limbs. 5th ed. Philadelphia: WB Saunders, 1998: 415-6.
[4]. Arey LB. Arteries of the limbs. In: Developmental Anatomy. 1st ed. Philadelphia: WB Saunders, 1966: 358-9.
[5]. Manners-Smith T. The limb arteries of primates. J Anat Physiol. 1910;45:23-64.
[6]. O’Sullivan E, Mitchell B. Association of the absence of palmaris longus tendon with an anomalous superficial palmar arch in the human hand. J Anat.2002;201:405-8.
https://doi.org/10.1046/j.0021-8782.2002.00109.x
PMid:12448775 PMCid:PMC1570962
[7]. Ikeda A, Ugawa A, Kazihara Y, Hamanda N. Arterial patterns in the hand based on a three-dimensional analysis of 220 cadaver hands. J Hand Surg. 1988;13:501-9.
https://doi.org/10.1016/S0363-5023(88)80085-6
[8]. Loukas M, Holdman D, Holdman S. Anatomical variations of the superficial and deep palmar arches. Folia Morphol. 2005 May;64(2):78-83.
[9]. Coleman SS, Anson BJ. Arterial patterns in the hand based upon the study of 650 specimens. Surg Gynecol Obstet. 1961;113:409-24.
[10]. Bilge O, Pinar Y, Ozer MA, Gövsa F. A morphometric study on the superficial palmar arch of the hand. Surg Radiol Anat. 2006 Aug;28(4):343-50
https://doi.org/10.1007/s00276-006-0109-9
PMid:16642281
[11]. Gellman H, Botte MJ, Shankwiler J, Gelberman RH. Arterial patterns of the deep and superficial palmar arches. Clin Orthop Relat Res. 2001;383E:41- 6.
https://doi.org/10.1097/00003086-200102000-00007
PMid:11210968
[12]. Rodriguez-Neidenfuhr M, Sanudo JR, Vazquez T, Nearn L, Logan B, Parkin I. Median artery revisited. J Anat. 1999;195:57-63.
https://doi.org/10.1017/S0021878299005075
https://doi.org/10.1046/j.1469-7580.1999.19510057.x
PMid:10473293 PMCid:PMC1467965
[13]. Al-Turk M, Metcalf WK. A study of the superficial palmar arteries using the Doppler Ultrasonic Flowmeter. J Anat. 1984;138(1):27-32.
[14]. Jiji PJ, D’Costa S, Nayak SR, Prabhu LV, Kumar CG, Prakash. A unique variation of superficial palmar arch. International Journal of Anatomical Variations. 2009;2105-7.
[15]. Salgado LSS, Hasan R, Perera AAMMSL, Wijesundara WMRD, Anuradha WK. Variations of the superficial palmar arch in a Sri Lankan perspective. GSTF J Adv Med Res. 2014;1(2):61-7.
https://doi.org/10.5176/2345-7201_1.2.25
[16]. Gupta C, Kalthur SG, Nair N, Pai SR. A morphological study of variations of superficial palmar arches of the hand. CHRISMED Journal of Health and Research. 2015 Apr-Jun;2(2):140-4.
https://doi.org/10.4103/2348-3334.153259
[17]. Jelicic N, Gajisin S, Zbrodowski A. Arcus palmaris superficialis. Acta Anat. 1988;132(3):187-90.
[18]. Bataineh ZM, MoqattashST. A complex variation in the superficial palmar arch. Folia Morphol;. 2006;65:406-9.
[19]. Tandler J. Zur. Anatomie der arterien der Hand. Anat Hefte. 1897;7:263-82.
https://doi.org/10.1007/BF02298035
[20]. Onderglu S, Basar R, Erbil KM, Cumhur M. Complex variation of the superficial palmar arch-Case report. Surg Radiol Anat. 1997;19(2):123-5.
https://doi.org/10.1007/s00276-997-0123-6
https://doi.org/10.1007/BF01628138
[21]. Fazan VP, Borges CT, Da Silva JH, Caetano AG, Filho OA. Superficial palmar arch: an arterial diameter study. J Anat. 2004 Apr;204(4):307-11.
https://doi.org/10.1111/j.0021-8782.2004.00281.x
PMid:15061757 PMCid:PMC1571293
