Newer insights in the anatomy of superficial palmar arch

The purpose of the study is to study and classify the superficial palmar arch and its variation based upon the gross dissection and to check the bilateral symmetry of the arches. Specifically, we checked for the presence of the superficial palmar arch as described in the standard textbooks.

We dissected 55 hands from 28 cadavers of both sexes that include 18 males and 10 females. The superficial palmar arch was carefully dissected and the arteries contributing its formation were traced. It was classified into complete, incomplete arches. Bilateral symmetry of the arches was also studied.

The most common pattern of superficial palmar arch observed is complete. And it is further classified into radio-ulnar and predominantly ulnar types. A consistent proportion of radio-ulnar type arch is completed around first web space. None of the dissected hand meets the definition of the classical superficial palmar arch as described in the standard anatomical textbooks. We also encountered few rare variants of the incomplete superficial palmar arch.

Type 1-4 superficial palmar arch is complete and can be utilized for radial artery or ulnar artery cannulation and radial artery harvesting procedure. In type 5 arch, ulnar artery occlusion could lead to severe hand ischemia and at the same time the radial artery in this type can be harvested without ischemic complication. We suggest that the definition of the complete superficial palmar arch should be rechecked and modified as complete superficial palmar or complete superficial first web space arch.