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CC BY-NC-ND 4.0 · Revista Iberoamericana de Cirugía de la Mano 2018; 46(02): 096-105
DOI: 10.1055/s-0038-1676046
Original Article | Artículo Original
Thieme Revinter Publicações Ltda Rio de Janeiro, Brazil

Anatomical Study of the Superficial Palmar Arch, its Relation to the Kaplan Cardinal Line and Literature Review

Article in several languages: English | español
Claudia Arroyo Berezowsky
1   Orthopedics and Hand Surgery, Instituto Nacional de Rehabilitación Luis Guillermo Ibarra Ibarra, Ciudad de México, Mexico
,
Alejandro Espinosa Gutiérrez
2   Hand Service, Instituto Nacional de Rehabilitación Luis Guillermo Ibarra Ibarra, Ciudad de México, Mexico
,
Jimena Quinzaños Fresnedo
3   Nuerological Rehabilitation Division, Instituto Nacional de Rehabilitación Luis Guillermo Ibarra Ibarra, Ciudad de México, Mexico
,
José Antonio Rivas Montero
2   Hand Service, Instituto Nacional de Rehabilitación Luis Guillermo Ibarra Ibarra, Ciudad de México, Mexico
› Author Affiliations
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Publication History

29 April 2018

10 October 2018

Publication Date:
07 December 2018 (online)

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Abstract

Introduction The superficial palmar arch is the main contributor to the vascular supply of the hand. Numerous anatomical variants have been described and there are multiple classifications of the superficial palmar arch available. The Kaplan cardinal line is used occasionally as a reference to identify the deep structures of the hand. However, there are also multiple variants of the line and multiple reports regarding the structures that can be identified with it.

Material and Methods Ten anatomical dissections of hands were performed in seven cadaveric specimens. The anatomical variants of the superficial palmar arch were recorded, as well as their relationship with the Kaplan cardinal line. A review of the available literature was made.

Results According to the classification by Coleman et al, the most common type was the complete superficial palmar arch, present in seven hands, while the incomplete superficial palmar arch was found in three hands. The most frequent complete palmar arch was type IB, followed by type IIB, and finally type IA and type IIA. The most common relation was with the Kaplan cardinal line type A to the apex of the arch and with type B to the curvature of the ulnar artery.

Conclusions There is a great anatomical variability in the superficial palmar arch. There was a greater frequency of the complete superficial palmar arch, with the ulnar artery being the dominant vascular supply. The Kaplan cardinal line can be used as a safety limit to avoid the superficial palmar arch if it is drawn to intersect the pisiform bone.

Clinical Relevance It is important to be aware of the anatomical variants of the superficial palmar arch, as well as of its relationship with the superficial structures of the hand to be able to perform invasive or reconstructive procedures and to preserve the vascularity of the hand.

Keywords

superficial palmar arch - hand - vascularity
 

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