Anatomical landmarks to the superficial and deep palmar arches

BACKGROUND: Knowledge of the relationship of the palmar arches to anatomical landmarks would decrease iatrogenic injuries, facilitate treatment of vascular occlusive disease, and ease interpretation of abnormal arteriograms. The purpose of this study was to identify the location of the palmar arches in relation to surface and bony landmarks. METHODS: The palmar arches in 48 cadavers were identified through dissection. The most distal points of the palmar arches were measured in relation to Kaplan's cardinal line, the distal wrist crease, and the carpometacarpal joint of the ring finger. The distances of the palmar arches to the radiocarpal joint were measured on 30 arteriograms. RESULTS: The superficial palmar arch and deep palmar arch were found to be on average 15.3 ± 8.60 mm and 6.70 ± 4.82 mm distal to Kaplan's cardinal line, respectively. The superficial palmar arch was found to be on average 51.8 ± 7.56 mm distal to the distal wrist crease, while the deep palmar arch was only 40.1 ± 7.92 mm from the distal wrist crease. The average distances from the superficial palmar arch and deep palmar arch to the carpometacarpal joint of the ring finger were 32.2 ± 6.33 mm and 18.3 ± 4.64 mm, respectively. On arteriography, the superficial palmar arch and deep palmar arch were on average 50.3 ± 8.61 mm and 44.89 ± 4.77 mm, respectively, from the radiocarpal joint. CONCLUSIONS: The superficial and deep palmar arches were located at consistent distances from easily identifiable surface and bony landmarks. Knowledge of these predictable anatomical relations would aid clinicians in surgical dissection, treatment of vascular occlusive disease, and interpretation of abnormal arteriograms when only one arch is present.