Morphological study of superficial palmar arch and the significance in clinical operation.

Abstract

BACKGROUND The superficial palmar arch is a crucial blood supply to the palm. However, it exhibits significant variations, posing challenges in surgical procedures. Gaining a comprehensive understanding of the relationship between different types, physiological indices, and the clinical significance of the superficial palmar arch will enhance the accuracy of diagnosing and treating patients. MATERIALS AND METHODS In this study, we dissected a total of 72 specimens, comprising 39 males and 33 females. We observed the type, length, and diameter of the superficial palmar arch and analyzed its correlation with the disease. Additionally, we conducted Doppler ultrasound measurements on 20 healthy volunteers (10 males and 10 females) and 18 patients with superficial palmar arch injury (10 males and 8 females) to assess the classification, diameter, intimal thickness, and blood flow velocity of the superficial palmar arch. We collected information on 9 male patients with finger fracture and observed the classification of the superficial palmar arch, fracture healing time, and basic function recovery time. Lastly, we analyzed rare variant specimens encountered during the anatomy process. RESULTS In the exploration of human anatomy, there were four types of superficial palmar arch: ulnar artery arch type in 17 cases (23.61%), radial ulnar artery type in 46 cases (63.89%), ulnar artery without arch type in 6 cases (8.33%), and 3 cases (4.17%) of double arch type of radial and ulnar artery. One case non-arched type was found in imaging examination (5%). In one elderly male specimen, the hand's superficial palmar arch artery was tortuous and dilated. In addition, there was a positive correlation between the diameter and length of the superficial palmar arch (except the second common palmar digital artery in women), among which the ulnar artery and the third common palmar digital artery had the strongest correlation. Compared to healthy volunteers, patients with ulnar injury in the Radial-ulnar artery type exhibited a decrease in the diameter and blood flow velocity of the ulnar artery, as well as the second and third common palmar digital arteries. No such change was observed in patients with radial injury. Additionally, patients with ulnar injury in other types of Radial-ulnar artery also experienced a decrease in the diameter and blood flow velocity of the ulnar artery. Finger fracture patients with Ulnar artery with arch and Ulnar artery without arch had shorter fracture healing time and basic function recovery time compared to those with Radial-ulnar artery type. CONCLUSIONS This study investigated the relationship between the classification, physiological index, and clinical significance of the superficial palmar arch at all levels. The results demonstrated that when the superficial palmar arch is damaged, it is important to consider both the classification and the site of damage, as this can potentially result in improved therapeutic outcomes. These findings provide a basis for future clinical research.