Perforating branches: important contribution to the formation of the dorsal metacarpal arteries

The perforating branches that originate from the deep palmar arch of the hand have been studied to provide a complete anatomical description of these vessels and assess their importance in the blood collateral pathway of the hand. We injected latex into the arteries of 50 cadaveric hands of 25 adults, of both sexes, all of Brazilian origin. These were dissected under a stereoscopic microscope. The perforating branch of the second interosseous space originated from the deep palmar arch in 80% of the cases, and it corresponded to the radial artery passing through the second space in 16%; the one of the third interosseous space originated from the deep palmar arch in 76% of the cases and from the palmar metacarpal artery of the third interosseous space in 16%; the one of the fourth interosseous space originated from the deep palmar arch in half the cases, from the deep palmar branch of the ulnar artery in 14%, and from the palmar metacarpal artery of this space in 18%. The perforating branch of the second space anastomosed with the second dorsal metacarpal artery (DMA) in 60% of the cases and formed it in 10%; the one of the third space anastomosed with the third DMA in 20% and formed it in 64%; the one of the fourth space anastomosed with the fourth DMA in 8% and formed it in 78%. These vessels are an important anastomotic pathway between the dorsal carpal network and the deep arteries of the hand and are important in the supply to the dorsum.