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Czasopismo

2018 | 77 | 4 |

Tytuł artykułu

The superficial palmar branch of the radial artery: a corrosion cast study

Warianty tytułu

Języki publikacji

EN

Abstrakty

EN
Background: Surgical procedures such as thenar flaps and radial artery (RA) harvesting call for an elaborate anatomical study of the RA’s superficial palmar branch (SPB). The aim of this study was to describe the branching pattern of this vessel related to the morphometric characteristics and variations of this artery. Materials and methods: Twenty 4% formalin solution-injected hands were dissected. For the morphometric study we used another group of 35 human hands of adult persons, injected with methyl methacrylate fluid into the ulnar and radial arteries. As soon as polymerisation was completed, a 40% solution of potassium hydroxide was applied for corrosion. The vascular arterial casts were examined under the stereoscopic microscope and precise drawings of each specimen were made. Results: In the majority of cases (75%) SPB passed superficially, over the abductor pollicis brevis muscle. The mean diameter of the SPB, very variable depending on its length and field of supply, was 1.52 ± 0.49 mm, ranging from 0.8 to 2.7 mm. Developed SPB type, was present in 31.4% of hands, with the diameter of 1.7 mm and larger (mean 1.95 mm), continuing distally to become the radialis indicis artery, with an average calibre of 1.2 mm, and with important branches to the thumb. In most hands (68.6%), the hypoplastic SPB, was present, with a mean diameter of 1.17 mm, and the field of supply within the thenar area. Conclusions: Knowledge of the SPB dominance and existence of anastomotic vessels in its field of supply are of importance to avoid the risk of possible ischaemic sequelae in the hand associated with harvesting the RA. (Folia Morphol 2018; 77, 4: 649–655)

Słowa kluczowe

Wydawca

-

Czasopismo

Rocznik

Tom

77

Numer

4

Opis fizyczny

p.649–655,fig.,ref.

Twórcy

autor
  • Faculty of Medicine, Institute for Orthopaedic Surgery and Traumatology, Clinical Centre of Serbia, University of Belgrade, Serbia
  • Faculty of Medicine, Institute for Orthopaedic Surgery and Traumatology, Clinical Centre of Serbia, University of Belgrade, Koste Todorovica 26, 11000 Belgrade, Serbia
autor
  • Medical Department, Faculty of Sport and Physical Education, University of K. Mitrovica, Serbia
autor
  • Department of Plastic, Reconstructive, and Hand Surgery, Faculty of Medicine, University of East Sarajevo, Foca, Republic of Srpska, Bosnia and Herzegovina
  • Faculty of Medicine, Institute for Orthopaedic Surgery and Traumatology, Clinical Centre of Serbia, University of Belgrade, Koste Todorovica 26, 11000 Belgrade, Serbia
autor
  • Faculty of Dentistry, Institute of Anatomy, University of Belgrade, Serbia, University of Belgrade, Serbia
autor
  • Department of Cellular Physiology and Metabolism, Faculty of Medicine, Anatomy Sector, University of Geneva, Switzerland
  • Faculty of Medicine, Institute for Orthopaedic Surgery and Traumatology, Clinical Centre of Serbia, University of Belgrade, Serbia

Bibliografia

  • 1. Baetz L, Satiani B. Palmar arch identification during evaluation for radial artery harvest. Vasc Endovascular Surg. 2011; 45(3): 255–257, doi: 10.1177/1538574411399159, indexed in Pubmed: 21478246.
  • 2. Bilge O, Pinar Y, Ozer MA, et al. A morphometric study on the superficial palmar arch of the hand. Surg Radiol Anat. 2006; 28(4): 343–350, doi: 10.1007/s00276-006-0109-9, indexed in Pubmed: 16642281.
  • 3. Brodman RF, Hirsh LE, Frame R. Effect of radial artery harvest on collateral forearm blood flow and digital perfusion. J Thorac Cardiovasc Surg. 2002; 123(3): 512–516, doi: 10.1067/mtc.2002.119885, indexed in Pubmed: 11882824.
  • 4. Cormack GC, Lamberty BGH. The arterial anatomy of skin flaps. Churchill Livingstone. 1994: 210–213.
  • 5. Fazan VP, Borges CT, Da Silva JH, et al. Superficial palmar arch: an arterial diameter study. J Anat. 2004; 204(4): 307–311, doi: 10.1111/j.0021-8782.2004.00281.x, indexed in Pubmed: 15061757.
  • 6. Feigl GC, Petrac M, Pixner T, et al. The superficial palmar arch and median artery as an example of misleading results due to a small number of investigated specimens or the use of different classifications. Ann Anat. 2012; 194(4): 389–395, doi: 10.1016/j.aanat.2011.10.013, indexed in Pubmed: 22196998.
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  • 12. Kwon YJ, Ahn BM, Lee JS, et al. Reconstruction of two fingertip amputations using a double thenar flap and comparison of outcomes of surgery using a single thenar flap. Injury. 2017; 48(2): 481–485, doi: 10.1016/j.injury.2016.12.023, indexed in Pubmed: 28057323.
  • 13. Loukas M, Holdman D, Holdman S. Anatomical variations of the superficial and deep palmar arches. Folia Morphol. 2005; 64(2): 78–83, indexed in Pubmed: 16121323.
  • 14. McLean KM, Sacks JM, Kuo YR, et al. Anatomical landmarks to the superficial and deep palmar arches. Plast Reconstr Surg. 2008; 121(1): 181–185, doi: 10.1097/01.prs.0000293863.45614.f9, indexed in Pubmed: 18176219.
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  • 18. Pistre V, Pelissier P, Martin D, et al. Vascular blood supply of the dorsal side of the thumb, first web and index finger: anatomical study. J Hand Surg Br. 2001; 26(2): 98–104, doi: 10.1054/jhsb.2000.0538, indexed in Pubmed: 11281658.
  • 19. Rodríguez-Niedenführ M, Burton GJ, Deu J, et al. Development of the arterial pattern in the upper limb of staged human embryos: normal development and anatomic variations. J Anat. 2001; 199(Pt 4): 407–417, indexed in Pubmed: 11693301.
  • 20. Ross AC. Wrist and Hand. In: Standring S (Editor-in-Chief), Gray’s anatomy. The anatomical basis of clinical practice. Elsevier Limited, Philadelphia. 2016: 862–897.
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  • 22. Seyhan T. Reverse thenar perforator flap for volar hand reconstruction. J Plast Reconstr Aesthet Surg. 2009; 62(10): 1309–1316, doi: 10.1016/j.bjps.2008.03.061, indexed in Pubmed: 18667372.
  • 23. Singh S, Lazarus L, De Gama BZ, et al. An anatomical investigation of the superficial and deep palmar arches. Folia Morphol. 2017; 76(2): 219–225, doi: 10.5603/FM.a2016.0050, indexed in Pubmed: 27665957.
  • 24. Thanik V, Shah A, Chiu D. A technique for tripartite reconstruction of fingertip injuries using the thenar flap with bone and nail bed grafts. J Hand Surg Am. 2017; 42(12): 1040.e1–1040.e7, doi: 10.1016/j.jhsa.2017.09.011, indexed in Pubmed: 29198319.
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  • 26. Zekavica A, Milisavljević M, Erić D, et al. Vascular anatomy of the thenar eminence: its relevance to a pedicled or free thenar flap. Folia Morphol. 2017; 76(2): 232–238, doi: 10.5603/FM.a2016.0077, indexed in Pubmed: 28026846.

Typ dokumentu

Bibliografia

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