Uncommon course of the common palmar digital artery of the fourth web space beneath the deep transverse metacarpal ligament: a cadaveric case report.

摘要

BACKGROUND: Anatomical variations of the palmar digital arteries are reported less frequently than variations of the superficial and deep palmar arches, particularly regarding their precise topographic relationships within the intermetacarpal spaces. The common palmar digital arteries are classically described as running volar to the deep transverse metacarpal ligament. MATERIALS AND METHODS: During routine anatomical dissection of a cryopreserved upper limb from an adult donor injected with red latex, the arterial pattern of the palm was examined with particular attention to the vessels supplying the fourth intermetacarpal space. RESULTS: The fourth common palmar digital artery was absent. A branch arising from the ulnar proper palmar digital artery of the little finger coursed from the hypothenar region toward the fourth intermetacarpal space, passed deep to the flexor digitorum profundus tendon of the little finger, and crossed beneath the deep transverse metacarpal ligament. Distal to the ligament, the vessel divided into the ulnar proper palmar digital artery of the fourth finger and the radial proper palmar digital artery of the fifth finger. CONCLUSIONS: This arterial configuration represents an uncommon topographic relationship between the palmar digital arteries and the deep transverse metacarpal ligament and differs from standard anatomical descriptions. Awareness of such variations contributes to anatomical knowledge and may be clinically relevant during surgical procedures involving the fourth web space of the hand.