Deep Palmar Arch in Man

WOS: 000270109600004Objective: The importance of the vascular anatomy of the hand is evident especially in reconstruction of congenital anomalies, posttraumatic lesions and radial artery (RA) harvesting to use as an arterial bypass conduit. This study was performed to expand the data reported in the literature about the deep palmar arch in man. Material and Methods: Fifty hands out of 25 formalin fixed and red-colored latex injected cadavers were dissected. The diameters of the contributing branches and the palmar metacarpal arteries were measured. The configurations of the arches were classified and were evaluated for bilateralism. The position of the deep branch of the ulnar nerve (DBUN) to the deep palmar arch (DPA) was also evaluated. Results: Three types of complete arch were determined; type A (32%), type B (40%) and type C (26%). Only one incomplete arch was found (2%). The mean diameters of the participating terminal part of the RA, and theproximal and distal deep branches of the ulnar artery (UA) were measured as 2.60 mm, 1.77 mm and 1.63 mm, respectively. The mean diameter of the first palmar metacarpal artery was 1.5 mm, the 2nd was 1.41 mm, and the 3rd was 1.45 mm. In 37 (74%) samples the DBUN crossed the DPA obliquely and dorsally, while in 12 (24%) samples it crossed the DPA on its palmar aspect. Conclusion: Understanding the arterial network and the variations of the hand is useful for surgical reconstruction procedures. Vessels of the deep arch have been found to be of sufficient size to allow microsurgical repair. The variable position of the DBUN in respect to the DPA is an important structure in this region surgery