open access

Vol 77, No 4 (2018)
ORIGINAL ARTICLES
Published online: 2018-03-30
Submitted: 2018-01-10
Accepted: 2018-03-14
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The superficial palmar branch of the radial artery: a corrosion cast study

M. Ilić, M. Milisavljević, A. Maliković, D. Laketić, D. Erić, J. Boljanović, A. Dožić, B. V. Štimec, R. Manojlovic
DOI: 10.5603/FM.a2018.0033
·
Pubmed: 29611162
·
Folia Morphol 2018;77(4):649-655.

open access

Vol 77, No 4 (2018)
ORIGINAL ARTICLES
Published online: 2018-03-30
Submitted: 2018-01-10
Accepted: 2018-03-14

Abstract

Background: Surgical procedures such as thenar flaps and radial artery (RA) harvesting call for an elaborate anatomical study of the RA’s superficial palmar branch (SPB). The aim of this study was to describe the branching pattern of this vessel related to the morphometric characteristics and variations of this artery.

Materials and methods: Twenty 4% formalin solution-injected hands were dissected. For the morphometric study we used another group of 35 human hands of adult persons, injected with methyl methacrylate fluid into the ulnar and radial arteries. As soon as polymerisation was completed, a 40% solution of potassium hydroxide was applied for corrosion. The vascular arterial casts were examined under the stereoscopic microscope and precise drawings of each specimen were made.

Results: In the majority of cases (75%) SPB passed superficially, over the abductor pollicis brevis muscle. The mean diameter of the SPB, very variable depending on its length and field of supply, was 1.52 ± 0.49 mm, ranging from 0.8 to 2.7 mm. Developed SPB type, was present in 31.4% of hands, with the diameter of 1.7 mm and larger (mean 1.95 mm), continuing distally to become the radialis indicis artery, with an average calibre of 1.2 mm, and with important branches to the thumb. In most hands (68.6%), the hypoplastic SPB, was present, with a mean diameter of 1.17 mm, and the field of supply within the thenar area.

Conclusions: Knowledge of the SPB dominance and existence of anastomotic vessels in its field of supply are of importance to avoid the risk of possible ischaemic sequelae in the hand associated with harvesting the RA.

Abstract

Background: Surgical procedures such as thenar flaps and radial artery (RA) harvesting call for an elaborate anatomical study of the RA’s superficial palmar branch (SPB). The aim of this study was to describe the branching pattern of this vessel related to the morphometric characteristics and variations of this artery.

Materials and methods: Twenty 4% formalin solution-injected hands were dissected. For the morphometric study we used another group of 35 human hands of adult persons, injected with methyl methacrylate fluid into the ulnar and radial arteries. As soon as polymerisation was completed, a 40% solution of potassium hydroxide was applied for corrosion. The vascular arterial casts were examined under the stereoscopic microscope and precise drawings of each specimen were made.

Results: In the majority of cases (75%) SPB passed superficially, over the abductor pollicis brevis muscle. The mean diameter of the SPB, very variable depending on its length and field of supply, was 1.52 ± 0.49 mm, ranging from 0.8 to 2.7 mm. Developed SPB type, was present in 31.4% of hands, with the diameter of 1.7 mm and larger (mean 1.95 mm), continuing distally to become the radialis indicis artery, with an average calibre of 1.2 mm, and with important branches to the thumb. In most hands (68.6%), the hypoplastic SPB, was present, with a mean diameter of 1.17 mm, and the field of supply within the thenar area.

Conclusions: Knowledge of the SPB dominance and existence of anastomotic vessels in its field of supply are of importance to avoid the risk of possible ischaemic sequelae in the hand associated with harvesting the RA.

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Keywords

superficial palmar branch, radial artery, anastomoses, radialis indicis artery

About this article
Title

The superficial palmar branch of the radial artery: a corrosion cast study

Journal

Folia Morphologica

Issue

Vol 77, No 4 (2018)

Pages

649-655

Published online

2018-03-30

DOI

10.5603/FM.a2018.0033

Pubmed

29611162

Bibliographic record

Folia Morphol 2018;77(4):649-655.

Keywords

superficial palmar branch
radial artery
anastomoses
radialis indicis artery

Authors

M. Ilić
M. Milisavljević
A. Maliković
D. Laketić
D. Erić
J. Boljanović
A. Dožić
B. V. Štimec
R. Manojlovic

References (26)
  1. Baetz L, Satiani B. Palmar arch identification during evaluation for radial artery harvest. Vasc Endovascular Surg. 2011; 45(3): 255–257.
  2. Bilge O, Pinar Y, Ozer MA, et al. A morphometric study on the superficial palmar arch of the hand. Surg Radiol Anat. 2006; 28(4): 343–350.
  3. Brodman RF, Hirsh LE, Frame R. Effect of radial artery harvest on collateral forearm blood flow and digital perfusion. J Thorac Cardiovasc Surg. 2002; 123(3): 512–516.
  4. Cormack GC, Lamberty BGH. The arterial anatomy of skin flaps. Churchill Livingstone. 1994: 210–213.
  5. Fazan VP, Borges CT, Da Silva JH, et al. Superficial palmar arch: an arterial diameter study. J Anat. 2004; 204(4): 307–311.
  6. Feigl GC, Petrac M, Pixner T, et al. The superficial palmar arch and median artery as an example of misleading results due to a small number of investigated specimens or the use of different classifications. Ann Anat. 2012; 194(4): 389–395.
  7. Fitoussi F, Ghorbani A, Jehanno P, et al. Thenar flap for severe finger tip injuries in children. J Hand Surg Br. 2004; 29(2): 108–112.
  8. Gaggl A, Bürger H, Brandtner C, et al. The microvascular thenar flap as a new possibility for super-thin soft tissue reconstruction in the oral cavity--initial clinical results. Br J Oral Maxillofac Surg. 2012; 50(8): 721–725.
  9. Gellman H, Botte MJ, Shankwiler J, et al. Arterial patterns of the deep and superficial palmar arches. Clin Orthop Relat Res. 2001(383): 41–46.
  10. Hugon S, Castus P, Schoofs M. Index reconstruction by means of a fasciocutaneous thenar flap. Plast Reconstr Surg. 2010; 126(1): 43e–44e.
  11. Klimek-Piotrowska W, Pacholczak R, Walocha J. Multiple variations of the arterial pattern in upper extremities: a case report and embryological pathogenesis. Clin Anat. 2013; 26(8): 1031–1035.
  12. Kwon YJ, Ahn BM, Lee JS, et al. Reconstruction of two fingertip amputations using a double thenar flap and comparison of outcomes of surgery using a single thenar flap. Injury. 2017; 48(2): 481–485.
  13. Loukas M, Holdman D, Holdman S. Anatomical variations of the superficial and deep palmar arches. Folia Morphol. 2005; 64(2): 78–83.
  14. McLean KM, Sacks JM, Kuo YR, et al. Anatomical landmarks to the superficial and deep palmar arches. Plast Reconstr Surg. 2008; 121(1): 181–185.
  15. Miletin J, Sukop A, Baca V, et al. Arterial supply of the thumb: Systemic review. Clin Anat. 2017; 30(7): 963–973.
  16. Moore KL, Dalley AF, Agur AMR. Clinicaly oriented anatomy. Lippincott Williams and Wilkins, Baltimore. 2014: 759–782.
  17. Omokawa S, Ryu J, Tang JB, et al. Vascular and neural anatomy of the thenar area of the hand: its surgical applications. Plast Reconstr Surg. 1997; 99(1): 116–121.
  18. Pistre V, Pelissier P, Martin D, et al. Vascular blood supply of the dorsal side of the thumb, first web and index finger: anatomical study. J Hand Surg Br. 2001; 26(2): 98–104.
  19. Rodríguez-Niedenführ M, Burton GJ, Deu J, et al. Development of the arterial pattern in the upper limb of staged human embryos: normal development and anatomic variations. J Anat. 2001; 199(Pt 4): 407–417.
  20. Ross AC. Wrist and Hand. In: Standring S (Editor-in-Chief), Gray’s anatomy. The anatomical basis of clinical practice. Elsevier Limited, Philadelphia. 2016: 862–897.
  21. Salmon M. Arteries of the skin. Churchill Livingston, London-New York. 1988: 32–34.
  22. Seyhan T. Reverse thenar perforator flap for volar hand reconstruction. J Plast Reconstr Aesthet Surg. 2009; 62(10): 1309–1316.
  23. Singh S, Lazarus L, De Gama BZ, et al. An anatomical investigation of the superficial and deep palmar arches. Folia Morphol. 2017; 76(2): 219–225.
  24. Thanik V, Shah A, Chiu D. A technique for tripartite reconstruction of fingertip injuries using the thenar flap with bone and nail bed grafts. J Hand Surg Am. 2017; 42(12): 1040.e1–1040.e7.
  25. Vidić B, Milisavljević M, Maliković A. Atlas of the human body, central nervous system and vascularization. Elsevier, Academic Press, London. 2017: 14–24.
  26. Zekavica A, Milisavljević M, Erić D, et al. Vascular anatomy of the thenar eminence: its relevance to a pedicled or free thenar flap. Folia Morphol. 2017; 76(2): 232–238.

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