Variation in Formation of Superficial Palmar Arches with Clinical Implications
Variation in Formation of Superficial Palmar Arches with Clinical Implications
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DOI：
10.7860/jcdr/2014/7078.4252
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发表时间：
2014-04-01
影响因子：
0.2
通讯作者：
Bahetee, B. H.
中科院分区：
文献类型：
--
作者：
Joshi, Sheeial Bhimprasad;Vatsalaswamy, P.;Bahetee, B. H.
背景：随着微血管外科技术的出现，对手部动脉血供变化的认识已经达到了一个重要的实际意义。手掌动脉的供应来源于前臂的两条主干动脉，即前臂的尺、尺动脉及其分支之间形成的两条吻合弓。目的：掌浅动脉弓在掌侧的形成存在变异。材料和方法：在本研究中，我们研究了印度浦那D.Y.Patil医学院和印度浦那B.J.政府医学院的100具身体手的掌浅弓的形成及其变异。结果与结论：根据Adachi的分类，最主要的类型是尺骨型弓(66%)。按Coleman和Anson分类，82%(组1)掌浅弓完整，极低(18%)不完全弓(组2)。这表明在大多数病例中存在侧支循环。考虑到冠状动脉搭桥术中的放射状动脉采集，这将导致最少的并发症。根据Coleman和Anson 1961对弓的分类表明，本研究中的主要类型是完全由尺动脉形成的I组(B型)(56%)。第二组(C型)的正中动脉和尺动脉形成不完全浅弓，发生率为4%。因此，在这种情况下，采集桡动脉进行冠状动脉搭桥术可能被证明是较低的致命性。这项研究是为了提供掌浅弓形成的数据，掌浅弓是大多数外科手术和手部损伤的吸引中心。
Background: Knowledge of the variations in the arterial supply of hand has reached a point of practical importance with the advent of microvascular surgery for revascularization, replantation and composite tissue transfers. Arterial supply of hand is derived from two anastomotic arches, formed between two main arteries of forearm i.e. radial, ulnar and their branches, in the palm.Objective: The superficial palmar arch shows variation in formation at the radial side. In the present study we have recorded its data which would help in its clinical and surgical implications.Material and Methods: In the present study we have studied the formation of superficial palmar arches and their variations in 100 cadaveric hands at Dr. D. Y. Patil Medical College, Pune and B. J. Government Medical College, Pune, India.Result and Conclusion: According to Adachi's classification the most predominant pattern obseved was of Ulnar type arch (66%). According to Coleman and Anson classification 82% showed complete (Group I) superficial palmar arches and a very low incidence (18%) of incomplete arches (Group II). This suggests that collateral circulation is present in majority of cases. This would result in least number of complications considering radial artery harvesting for coronary bypass. Sub-classification of arches according to Coleman and Anson 1961 indicates that the predominant type in the present study was of Group I (Type B) which is formed entirely by Ulnar Artery (56%). Median artery and ulnar artery forming an incomplete superficial arch under Group II (Type C) having an incidence of 4% was recorded. Thus in such cases radial artery harvesting for coronary artery bypass may prove to be less fatal. This study is an effort to provide data about the formation of superficial palmar arches which has been a centre of attraction for most of the surgical procedures and injuries of the hand.