McLean Kia M, Sacks Justin M, Kuo Yur-Ren, Wollstein Ronit, Rubin J Peter, Andrew Lee W P
Pittsburgh, Pa.; and Kaohsiung, Taiwan From the Division of Plastic and Reconstructive Surgery, University of Pittsburgh, and Chang Gung Memorial Hospital.
Plast Reconstr Surg. 2008 Jan;121(1):181-185. doi: 10.1097/01.prs.0000293863.45614.f9.
Knowledge of the relationship of the palmar arches to anatomical landmarks would decrease iatrogenic injuries, facilitate treatment of vascular occlusive disease, and ease interpretation of abnormal arteriograms. The purpose of this study was to identify the location of the palmar arches in relation to surface and bony landmarks.
The palmar arches in 48 cadavers were identified through dissection. The most distal points of the palmar arches were measured in relation to Kaplan's cardinal line, the distal wrist crease, and the carpometacarpal joint of the ring finger. The distances of the palmar arches to the radiocarpal joint were measured on 30 arteriograms.
The superficial palmar arch and deep palmar arch were found to be on average 15.3 +/- 8.60 mm and 6.70 +/- 4.82 mm distal to Kaplan's cardinal line, respectively. The superficial palmar arch was found to be on average 51.8 +/- 7.56 mm distal to the distal wrist crease, while the deep palmar arch was only 40.1 +/- 7.92 mm from the distal wrist crease. The average distances from the superficial palmar arch and deep palmar arch to the carpometacarpal joint of the ring finger were 32.2 +/- 6.33 mm and 18.3 +/- 4.64 mm, respectively. On arteriography, the superficial palmar arch and deep palmar arch were on average 50.3 +/- 8.61 mm and 44.89 +/- 4.77 mm, respectively, from the radiocarpal joint.
The superficial and deep palmar arches were located at consistent distances from easily identifiable surface and bony landmarks. Knowledge of these predictable anatomical relations would aid clinicians in surgical dissection, treatment of vascular occlusive disease, and interpretation of abnormal arteriograms when only one arch is present.
了解掌弓与解剖标志的关系可减少医源性损伤,便于治疗血管闭塞性疾病,并有助于解读异常动脉造影片。本研究的目的是确定掌弓相对于体表和骨性标志的位置。
通过解剖确定48具尸体的掌弓。测量掌弓最远端点相对于卡普兰基线、腕部远侧横纹和环指掌指关节的距离。在30张动脉造影片上测量掌弓至桡腕关节的距离。
发现浅掌弓和深掌弓分别平均位于卡普兰基线远侧15.3±8.60mm和6.70±4.82mm处。浅掌弓平均位于腕部远侧横纹远侧51.8±7.56mm处,而深掌弓距腕部远侧横纹仅40.1±7.92mm。浅掌弓和深掌弓至环指掌指关节的平均距离分别为32.2±6.33mm和18.3±4.64mm。在动脉造影上,浅掌弓和深掌弓距桡腕关节的平均距离分别为50.3±8.61mm和44.89±4.77mm。
浅掌弓和深掌弓与易于识别的体表和骨性标志保持一致的距离。了解这些可预测的解剖关系将有助于临床医生进行手术解剖、治疗血管闭塞性疾病以及在仅存在一个掌弓时解读异常动脉造影片。