Variations in the superficial palmar arch of the hand

Variations in the pattern of the hand blood supply are frequently encountered. Awareness and identification of such variations is crucial during hand surgery. Thirty formaline fixed hands of male and female cadavers were dissected. All arteries contributing to the superficial palmar arch (SPA) of the hand were verified. In addition to the frequently encountered types of SPA, three very rare cases were described. In the first case, the superficial branch of the radial artery passed superficial to the thenar muscles with a diameter larger than that of the ulnar artery. In addition to the common palmar digital artery to the second web space, it gave the princeps pollicis and radialis indicis arteries. In the second case, the SPA was formed by the ulnar artery and was completed by a small branch from the deep branch of the radial artery. The palmar digital artery to the ulnar side of the fifth finger and the common palmar digital artery to the fourth web space arose from a common trunk. In the third case, incomplete SPA was formed by the median artery which only gave the princeps pollicis and radialis indicis arteries, while the ulnar artery supplied the rest of the hand except the ulnar side of the third finger and the second web space which were supplied by the deep palmar arch. Therefore, sound knowledge of the pattern of the blood supply of the hand by various techniques is crucial to avoid possible complications during hand surgery.