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

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.

Estudo anatômico da relação entre a anastomose de Riché-Cannieu e a linha cardinal de Kaplan

“…Some authors have related the KCL with the arterial arches of the palmar surface of the hand. 19 20 21 22 Panchal and Trzeciak 19 performed an anatomical study on 30 cadavers, dissecting 60 hands, to describe the relationship between the KCL and the superficial palmar arterial arch. They believe that, from a clinical point of view, the KCL is the most predictable marker to identify the superficial palmar arch.…”

“…Alguns autores 19 20 21 22 relacionaram a LCK aos arcos arteriais da superfície palmar da mão. Panchal e Trzeciak 19 realizaram um estudo anatômico em 30 cadáveres, e dissecaram 60 mãos para descrever a relação entre a LCK e o arco arterial palmar superficial.…”

“…Alguns autores [19][20][21][22] No Brasil, encontramos apenas um estudo 24 que relacionou estruturas da palma da mão com as pregas existentes; nesse estudo, os autores relacionaram os arcos arteriais superficiais e profundos com as pregas do punho.…”

Use of magnetic port finder for metallic foreign body extraction in hand

“…However, it is not available in all facilities and can have associated complications, such as dermatitis and radiation burns, with prolonged use. 7 During tissue expansion, localization devices are used to locate the metal base port for directing the syringe and performing the instillation, avoiding damage to the expander. Magnetic tissue expander locators aim to be an alternative tool for localizing FBs through magnetism, providing a fast, accessible, and safe method, as most plastic surgery centers already have such a device.…”

Analysis of the vascular pattern in the superficial palmar arch formation

“…The superficial branch of the ulnar artery forms the main part of the arch, which is accomplished on the lateral side by a branch from the radial artery. [8][9][10][11][12] . The SPA is the main focus for the majority of operations and traumatic occurrences in the hand.…”