Anatomy and Cell Biology

Korean Association of Anatomists (대한해부학회)
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Reappraisal of arterial anatomy of thumb

  • Dhivyalakshmi Gnanasekaran (Department of Anatomy, Indira Gandhi Medical College and Research Institute) ;
  • Raveendranath Veeramani (Department of Anatomy, Jawaharlal Institute of Postgraduate Medical Education and Research) ;
  • Aravindhan Karuppusamy (Department of Anatomy, Jawaharlal Institute of Postgraduate Medical Education and Research)
  • Received : 2022.03.08
  • Accepted : 2022.07.12
  • Published : 2022.12.31
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Abstract

The nomenclature of arteries supplying the thumb and its sources arteries differs between the studies. This makes difficulty in understanding the irrigation pattern to the thumb. The main purpose of this study was to identify the proper digital arteries supplying the thumb on its radial and ulnar side from both the palmar and dorsal aspect. Also this study aimed to trace its source and classify with proper definition with the review of blood supply to thumb. Dissection was carried out in 55 hands form 28 freshly embalmed adult human cadavers of both genders. The proper digital arteries to the thumb and its source arteries were carefully traced and defined. Thumb receives its dominant blood supply mostly from its palmar side. The ulnar palmar digital artery was seen in all the dissected hand (100.0%) whereas; the radial palmar digital artery was present in 53 hands (96.4%). The radial dorsal digital artery and ulnar dorsal digital artery were observed in only 10.0% and 7.3%. The most common source of both the palmar digital arteries to thumb was from first palmar metacarpal artery (FPMA). In majority of the hands, in addition to the radial or ulnar palmar digital arteries from the FPMA, there were also additional palmar digital arteries arising from the superficial palmar arterial system. The universal naming of the proper digital arteries to the thumb as well as its source arteries is mandatory for the proper understanding of normal as well as variant arterial anatomy of thumb.

Keywords

Acknowledgement

We sincerely thank the relatives of the cadavers who have donated the bodies for the research purpose.

References

  1. Cho SH, Bahar-Moni AS, Park HC. Thumb replantation using the superficial palmar branch of the radial artery. J Hand Microsurg 2016;8:106-8.
  2. Parks BJ, Arbelaez J, Horner RL. Medical and surgical importance of the arterial blood supply of the thumb. J Hand Surg Am 1978;3:383-5.
  3. Hierner R, Putz R, Bishop AT, Shen ZL, Wilhelm K, Brugger U, Kellner L, Rintelen H. Flaps in hand and upper limb reconstruction: surgical anatomy, operative techniques and differential therapy. Munchen: Urban & Fischer; 2013.
  4. Schlenker JD, Kleinert HE, Tsai TM. Methods and results of replantation following traumatic amputation of the thumb in sixty-four patients. J Hand Surg Am 1980;5:63-70.
  5. Ames EL, Bissonnette M, Acland R, Lister G, Firrell J. Arterial anatomy of the thumb. J Hand Surg Br 1993;18:427-36.
  6. Biant LC. Elbow and forearm. In: Standring S, editor. Gray's Anatomy: The Anatomical Basis of Clinical Practice. 41st ed. Philadelphia: Elsevier Limited; 2016. p.837-61.
  7. Earley MJ. The arterial supply of the thumb, first web and index finger and its surgical application. J Hand Surg Br 1986;11:163-74.
  8. Al-Turk M, Metcalf WK. A study of the superficial palmar arteries using the Doppler ultrasonic f lowmeter. J Anat 1984;138(Pt 1):27-32.
  9. Bilge O, Pinar Y, Ozer MA, Govsa F. A morphometric study on the superficial palmar arch of the hand. Surg Radiol Anat 2006;28:343-50.
  10. Coleman SS, Anson BJ. Arterial patterns in the hand based upon a study of 650 specimens. Surg Gynecol Obstet 1961;113:409-24.
  11. Fazan VP, Borges CT, Da Silva JH, Caetano AG, Filho OA. Superficial palmar arch: an arterial diameter study. J Anat 2004;204:307-11.
  12. Ikeda A, Ugawa A, Kazihara Y, Hamada N. Arterial patterns in the hand based on a three-dimensional analysis of 220 cadaver hands. J Hand Surg Am 1988;13:501-9.
  13. Murakami T, Takaya K, Outi H. The origin, course and distribution of arteries to the thumb, with special reference to the so-called A. princeps pollicis. Okajimas Folia Anat Jpn 1969;46:123-37.
  14. Nunley JA, Goldner RD, Urbaniak JR. Thumb reconstruction by the wrap-around method. Clin Orthop Relat Res 1985;195:97-103.
  15. Ramirez AR, Gonzalez SM. Arteries of the thumb: description of anatomical variations and review of the literature. Plast Reconstr Surg 2012;129:468e-76e.
  16. Miletin J, Sukop A, Baca V, Kachlik D. Arterial supply of the thumb: systemic review. Clin Anat 2017;30:963-73.
  17. Cunningham DJ. Cunningham's manual of practical anatomy. Vol 1. 15th ed. Oxford: Oxford University Press; 2005.
  18. Gnanasekaran D, Veeramani R. Newer insights in the anatomy of superficial palmar arch. Surg Radiol Anat 2019;41:791-9.
  19. Tan RES, Lahiri A. Vascular anatomy of the hand in relation to flaps. Hand Clin 2020;36:1-8.
  20. Omokawa S, Tanaka Y, Ryu J, Kish VL. The anatomical basis for reverse first to fifth dorsal metacarpal arterial flaps. J Hand Surg Br 2005;30:40-4.