Morphometric Study on the Arterial Palmar Arch of the Hand

손바닥 동맥활에 관한 형태계측 연구

  • Park, Bong Kwon (Double U Aesthetic Center) ;
  • Jang, Soo Won (Department of Plastic and Reconstructive Surgery, College of Medicine, Hanyang University) ;
  • Choi, Seung Suk (Department of Plastic and Reconstructive Surgery, College of Medicine, Hanyang University) ;
  • Ahn, Hee Chang (Department of Plastic and Reconstructive Surgery, College of Medicine, Hanyang University)
  • 박봉권 (더블유 성형외과) ;
  • 장수원 (한양대학교 의과대학 성형외과학 교실) ;
  • 최승석 (한양대학교 의과대학 성형외과학 교실) ;
  • 안희창 (한양대학교 의과대학 성형외과학 교실)
  • Published : 2009.11.15

Abstract

Purpose: Deviations of arterial palmar arches in the hand can be explained on the embryological basis. The purpose of this study was to provide new information about palmar arches through cadaver's dissection. The values of the location and diameter in these vessels were analyzed in order to support anatomical research and clinical correlation in the hand. Methods: The present report is based on an analysis of dissections of fifty - three hands carried out in the laboratory of gross anatomy. A reference line was established on the distal wrist crease to serve as the X coordinate and a perpendicular line drawn through the midpoint between middle and ring fingers, which served as the Y coordinate. The coordinates of the x and y values were measured by a digimatic caliper, and statistically analyzed with Student's t - test. Results: Complete superficial palmar archs were seen in 96.2 % of specimens. In the most common type of males, the superficial arch was formed only by the ulnar artery. In the most common type of females, the superficial arch was formed anastomosis between the radial artery and the ulnar artery. The average length of the superficial and deep palmar arch is $110.3{\pm}33.0mm$ and $67.9{\pm}14.0mm$ respectively. Regarding the superficial palmar arch, ulnar artery starts $-16.1{\pm}5.1mm$ on X - line, and $2.5{\pm}24.5mm$ on Y - line. Radial artery appears on palmar side $7.7{\pm}3.2mm$ on X - line, and $20.9{\pm}10.9mm$ on Y - line. But radial artery starts on $6.3{\pm}3.6mm$ on X - line, and $3.4{\pm}5.1mm$ on Y - line. Digital arteries of superficial palmar arch starts on $6.1{\pm}3.7mm$, $33.9{\pm}8.8mm$ on index finger, $1.8{\pm}3.4mm$, $40.1{\pm}7.3mm$ on middle finger, $-3.2{\pm}4.9mm$, $42.6{\pm}7.0mm$ on ring finger, and $-8.9{\pm}5.1mm$, $42.5{\pm}80mm$ on little finger in respective X and Y coordinates. Radial artery of deep palmar arches measured at the palmar side perforating from the dorsum of hand. It's coordinates were $9.7{\pm}4.8mm$ on X - line, $21.7{\pm}10.2mm$ on Y - line. Ulnar artery was measured at hypothenar area, and it's coordinates were $-20.4{\pm}6.3mm$ on X - line, and $30.6{\pm}7.4mm$ on Y - line. Conclusions: Anatomically superficial palmar arch can be divided into a complete and an incomplete type. Each of them can be subdivided into 4 types. The deep palmar arch is less variable than the superficial palmar arch. We believe these values of the study will be used for the vascular surgery of the hand using the endoscope and robot in the future.

Keywords

References

  1. Maccormack LJ, Cauldwell EW, Anson BJ: Brachial and antebrachial arterial patterns; a study of 750 extremities. Surg Gynecol Obstet 96: 43, 1953
  2. Coleman SS, Anson BJ: Arterial patterns in the hand based upon a study of 650 specimens, Surg Gynecol Obstet 113: 409, 1961
  3. Lee DL, Jang KY: Arterial distribution in the hand of korea. Korean J Ana 18: 221, 1985
  4. Jelicic N, Gajisin S, Zbrodowski A: Arcus palmaris superficialis. Acta Anat 132: 187, 1988
  5. Gajisin S, Zbrodowski A: Local vascular contribution of the superficial palmar arch. Acta Anat 147: 248, 1993 https://doi.org/10.1159/000147512
  6. Gellman H, Botte MJ, Shankwiler J, Gelberman RH: Arterial patterns of the deep and superficial palmar arches. Clin Orthop Relat Res 383: 41, 2001 https://doi.org/10.1097/00003086-200102000-00007
  7. Singer E: Embryological pattern persisting in the arteries of the arm. Anat Rec 55: 403, 1933 https://doi.org/10.1002/ar.1090550407
  8. Fazan VP, Borges CT, Silva JH, Caetano AG, Filho OA: Superficial palmar arch: an arterial diameter study. J Anat 204: 307, 2004 https://doi.org/10.1111/j.0021-8782.2004.00281.x
  9. Al-Turk M, Metcalf WK: A study of the superficial palmar arteries using the doppler ultrasonic flowmeter, J Anat 138: 27, 1984
  10. Balas P, Katsonginannis A, Katsiotis P, Karaitianos J: Comparative study of evaluation of digital arterial circulation by doppler ultrasonic tracing and hand arteriography. J Cardiovasc Surg 21: 455, 1980
  11. Edwards EA: Organization of the small arteries of the hand and digits. Am J Surg 99: 837, 1960 https://doi.org/10.1016/0002-9610(60)90472-4