43 - Superficial Course of the Palmar Branch of Radial Artery in the Hand: A Rare Cadaveric Finding

Poster Board Number: 43
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Abstract Body : The blood supply of the hand is provided by the radial and ulnar arteries. The radial artery (RA) gives off two branches – palmar carpal and superficial palmar (SPRA), before turning dorsally at the radial styloid process, passes deep to the tendons of the extensor pollicis brevis and abductor pollicis longus muscles, and enters the hand by piercing the first dorsal interosseous muscle. The SPRA enters the hand by piercing the thenar muscles and joins the ulnar artery (UA) to form the superficial palmar arch (SPA). The princeps pollicis artery (PPA), which provides blood supply to the thumb, typically originates from the RA as it turns into the palm to form the deep palmar arch. The radialis indicis artery (RIA), which provides blood supply to the radial side of the index finger, originates from the RA after it gives off the PPA. In this case report, we document two anatomical variations in the arterial network in the right hand of a 100-year-old Caucasian female donor. First, the SPRA entered the hand superficial to the thenar muscles instead of piercing them. Second, after providing a communicating branch to SPA in the hand, the SPRA branched into PPA and RIA. Some cadaver and imaging-based studies have reported variations in the course of SPRA and the origin of PPA. Unique variations of SPRA and its distributaries are vulnerable to iatrogenic injury during surgical procedures; hand surgeons must, therefore, be cognizant of arterial variations when performing surgical procedures such as vascular repairs, vascular graft applications, and free and/or pedicled flaps.