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Updated: Aug 22, 2025

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Published on: May 23, 2025
Hand size affects branching of the deep ulnar nerve and deep palmar arch
Mark D Orland1, Ye Lin1, Julio C Castillo Tafur1
1Department of Orthopaedic Surgery, University of Illinois, Chicago, 835S Wolcott Ave, Suite E290, Chicago, IL, 60612, USA.
Purpose:
Understanding the anatomy of the deep neurovascular structures of the hand is essential in surgical planning. There is a lack of literature regarding hand size and its influence in branching variation and the distances between branches of various neurovascular structures. Our study quantifies the variation in branching distances of the deep ulnar nerve and deep palmar arch branches.
Methods:
Twenty-five fresh-frozen cadaveric hands were dissected. Each branch of the deep ulnar nerve and deep palmar arch was identified. The distance from the most distal portion of the pisiform to the proximal aspect of the branch was measured. The relationship between the length of the third metacarpal and the distance of each branch from the pisiform was examined.
Results:
There was no relationship between branching differences in the deep ulnar nerve and the length of the third metacarpal. There was a significant association between the length of the third metacarpal and the second, third, and fourth branches of the deep palmar arch (p < 0.05).
Conclusions:
Our study found a significant association between the branching distances of the second, third, and fourth branches of the deep palmar arch and hand size as measured by the length of the third metacarpal.
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