Subcutaneous superficial palmar arch – an unusual variant

Introduction Arterial arches of hand are the major blood supply to the structures in the hand. The two arches, superficial and deep palmar arches make an important anastomose between the radial and ulnar arteries. Superficial palmar arch (SPA) is formed by direct continuation of ulnar artery, i.e. superficial palmar branch, completed on lateral side by one of the three branches of radial artery [1]. It usually is deep to the palmar aponeurosis, which is formed by deep fascia and palmaris longus tendon. Like the arterial variations in the other parts of body, the variations in arterial arches of hand are also common. These variations are found in formation of arch or in branching pattern of arch. A study of 200 hands by Loukas et al. showed complete SPA in 90% of cases and divided into five types, while the remaining 10% possessed an incomplete palmar arch [2]. Patterned variations are quite common in SPA [3]. A study of the superficial palmar arteries by Al-Turk et al. using the Doppler ultrasonic flowmeter on 50 hands revealed a complete arch in 84% of the cases [4]. Thus high incidence of anatomical variations in the arterial pattern of the hand has been the subject of many anatomical studies. All these variations recorded in the literature are regarding the source arteries for the formation of SPA and the variability of branching pattern. We have come across a variation of SPA not recorded till date and we considered it as important to put in the record of literature.