Anatomy of the radial branches of the palmar arch. Variations and surgical importance.

In this study, the authors present the results of the investigation of arteries that replace digital collaterals of the radial side of the hand when the superficial palmar arch (SPA) does not develop completely. The replacement occurs with the first interosseous dorsal and the first interosseous palmar arteries. The former takes place through the middle developed branch that issues the radial collateral of the thumb and the ulnar collateral of the little finger whereas the latter takes place in three cases: a) presence of a branch entering into the retroadductor space and finishing like the previously mentioned; b) the origin of the trunk of the ulnar collateral of the thumb finger and the radial collateral of the index finger; c) due to the origin of both collaterals of the thumb finger. In cases when the SPA does not issue the fourth palmar collateral, this one is replaced by the second palmar interosseous artery, a branch of the deep palmar arch. These three arteries are combined to form three different basic kinds of arterial replacement that are described, adding a fourth group of exceptions that does not fit into any of the categories mentioned previously.