Singh S, Lazarus L, De Gama B Z, Satyapal K S
Department of Clinical Anatomy, School of Laboratory Medicine and Medical Sciences, College of Health Sciences, Westville Campus, University of KwaZulu Natal, Durban, South Africa, South Africa.
Folia Morphol (Warsz). 2017;76(2):219-225. doi: 10.5603/FM.a2016.0050. Epub 2016 Sep 26.
The superficial palmar arch (SPA) and deep palmar arch (DPA) provide the dominant vascular supply to the hand. The SPA is considered to be highly variable and can be classified as either complete or incomplete. The simplest definition states that the anastomosis between the vessels contributing to the arch represent a complete arch, while an incomplete arch is described as characterised by an absence of anastomosis between the vessels contributing to it. This study aimed to describe the anatomical landmarks, formation and branching patterns of the SPA and DPA. In this study, the SPA and DPA were dissected in 50 specimens (n = 100 adult hands), respectively.
A complete SPA was observed in 92% of specimens and classified into three types. In Type A (44%), the SPA was formed by the anastomosis of the superficial palmar branch of the radial artery with the ulnar artery. Type B (46%) was formed by the ulnar artery alone and Type C (2%) was formed by anastomosis of the ulnar artery with the superficial palmar branch of the radial artery and the persistent median artery.
An incomplete SPA was observed in 8% of the specimens and divided into three types formed by the radial and ulnar arteries. The DPA was divided into five types viz. Type G (72%), where the DPA was formed by anastomosis of the deep palmar branch of the radial artery (DPBRA) with the deep palmar branch of the ulnar artery (DPBUA). Type H (12%), was formed by anastomosis of the DPBRA, the DBUA and the interosseous artery. Type I (8%), was formed by the anastomosis of the DPBRA with the superior and inferior DPBUA. Type J (4%), the deep ulnar artery had two branches whereby either one branch anastomosed with the DPBRA to form the DPA. Type K (4%), the DBUA exhibited two deep branches with one branch anastomosing with the DPBRA to complete the DPA.
The interosseous artery anastomosed with either the DPA or the additional DPBUA. Knowledge of the variability of the SPA and DPA is crucial for safe and successful hand surgeries.
掌浅弓（SPA）和掌深弓（DPA）为手部提供主要的血管供应。掌浅弓被认为变异很大，可分为完全型或不完全型。最简单的定义是，构成掌浅弓的血管之间的吻合代表完全型掌浅弓，而不完全型掌浅弓的特征是构成它的血管之间没有吻合。本研究旨在描述掌浅弓和掌深弓的解剖标志、形成及分支模式。在本研究中，分别对50个标本（n = 100只成人手）的掌浅弓和掌深弓进行了解剖。
92%的标本观察到完全型掌浅弓，并分为三种类型。A型（44%），掌浅弓由桡动脉掌浅支与尺动脉吻合形成。B型（46%）由尺动脉单独形成，C型（2%）由尺动脉与桡动脉掌浅支及正中动脉持续存在吻合形成。
8%的标本观察到不完全型掌浅弓，分为由桡动脉和尺动脉形成的三种类型。掌深弓分为五种类型，即G型（72%），掌深弓由桡动脉掌深支（DPBRA）与尺动脉掌深支（DPBUA）吻合形成。H型（12%），由DPBRA、DBUA和骨间动脉吻合形成。I型（8%），由DPBRA与尺动脉掌深支的上下支吻合形成。J型（4%），尺动脉深支有两个分支，其中一个分支与DPBRA吻合形成掌深弓。K型（4%），DBUA有两个深支，其中一个分支与DPBRA吻合完成掌深弓。
骨间动脉与掌深弓或额外的尺动脉掌深支吻合。了解掌浅弓和掌深弓的变异对于安全、成功地进行手部手术至关重要。
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