A study on variations in the formation of superficial palmar arches and its clinical significance in hand surgeries
Samata Roshini Padala, Jayasree Chada
The superficial palmar arch (SPA) is a major source of blood supply to much of the palm and is conventionally formed by the union of the ulnar artery with the superficial branch of the radial artery. The SPA has been classified into complete or incomplete based on the presence or absence of anastomosis between the arteries contributing to the formation of this palmar arch. The present study was undertaken to study the morphology of the Superficial Palmar Arch and observe the variation in its formation with an emphasis on its clinical relevance. The study was conducted on 21 formalin fixed randomly selected hand cadaver sample specimens of both male and female genders procured from the Department of Anatomy, Osmania Medical College, Hyderabad, Department of Clinical Anatomy, Rajiv Gandhi Institute of Medical Sciences, Adilabad and Surabhi Institute of Medical Sciences, Siddipet, Telangana, India. On careful and meticulous dissection, out of 21 hand cadavers studied, twenty cadavers showed the classic SPA. In all these cases the arch was formed by anastomosis between superficial branches of radial and ulnar arteries (95.24%) and incomplete superficial palmar arches was observed in 1 (4.8%) cadaver sample. The variation from the normal classical pattern was observed in 1 (4.8%) cadaver, aged about 65 years showed the formation of superficial palmar arch by the median artery (a. nervi mediana). Right side anterior interosseous artery gave origin to the median artery, which is accompanying median nerve (uncommon). This artery participated in the formation of superficial palmar arch. The median artery after taking origin from anterior interosseous artery ran along median nerve for about 2 cm, then pierced the nerve and passed lateral to it up to the flexor retinaculum. It passed under flexor retinaculum, later joined the ulnar artery to form superficial palmar arch. Hence, the comprehensive knowledge of such anatomical variations of the vascular supply for the hand is very important for successful surgeries and better outcome.