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Journal of the Korean Society of Plastic and Reconstructive Surgeons 2009;36(6):691-701.
Published online November 1, 2009.
Morphometric Study on the Arterial Palmar Arch of the Hand.
Bong Kwon Park, Soo Won Jang, Seung Suk Choi, Hee Chang Ahn
1Department of Plastic and Reconstructive Surgery, College of Medicine, Hanyang University, Seoul, Korea. ahnhc@hanyang.ac.kr
2Double U Aesthetic Center, Seoul, Korea.
Abstract
PURPOSE
Deviations of arterial palmar arches in the hand can be explained on the embryological basis. The purpose of this study is 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 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 +/- 33.0 mm and 67.9 +/- 14.0 mm respectively. Regarding the superficial palmar arch, ulnar artery starts -16.1 +/- 5.1 mm on X-line, and 2.5 +/- 24.5 mm on Y-line. Radial artery appears on palmar side 7.7 +/- 3.2 mm on X-line, and 20.9 +/- 10.9 mm on Y-line. But radial artery starts on 6.3 +/- 3.6 mm on X-line, and 3.4 +/- 5.1 mm on Y-line. Digital arteries of superficial palmar arch starts on 6.1 +/- 3.7 mm, 33.9 +/- 8.8 mm on index finger, 1.8 +/- 3.4 mm, 40.1 +/- 7.3 mm on middle finger, -3.2 +/- 4.9 mm, 42.6 +/- 7.0 mm on ring finger, and -8.9 +/- 5.1 mm, 42.5 +/- 80 mm 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 +/- 4.8 mm on X-line, 21.7 +/- 10.2 mm on Y-line. Ulnar artery was measured at hypothenar area, and it's coordinates were -20.4 +/- 6.3 mm on X-line, and 30.6 +/- 7.4 mm 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: Arterial palmar arch; Morphometric study
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