Variations in the formation of superficial palmar arch and its clinical significance in hand surgeries

The superficial palmar arch (SPA) and its contributing arteries are highly variable. The superficial palmar arch is usually formed by the superficial branch of ulnar artery and completed by one of the branch of radial artery i.e. superficial palmar branch, arteria radialis indicis or arteria princeps pollicis. It is rarely completed by the axis artery of the upper limb i.e. median artery which accompanies the median nerve. The present study was undertaken to investigate the presence of the median artery and its contribution to the formation of superficial palmar arch in 50 cadavers i.e. 100 upper limbs of Indian origin. Out of these, the median artery was found in 10 upper limbs. In 6 upper limbs the median artery took part in the formation of SPA and in the rest of four upper limbs, the median artery did not contribute to the formation of SPA. Of 6 upper limbs, the median artery anatomized with ulnar artery in four cases and in 2 cases the median artery formed incomplete arch with the ulnar artery. The outer diameter of the median artery ranged between 0.6 to 2.4 mm. The present study of median artery, its origin, course and its contribution to the SPA will add to the existing knowledge of the reconstructive hand surgical procedures such as arterial repairs, vascular graft applications and re-implantations.