Abstract
Introduction The superficial palmar arch is the main contributor to the vascular supply of the
hand. Numerous anatomical variants have been described and there are multiple classifications
of the superficial palmar arch available. The Kaplan cardinal line is used occasionally
as a reference to identify the deep structures of the hand. However, there are also
multiple variants of the line and multiple reports regarding the structures that can
be identified with it.
Material and Methods Ten anatomical dissections of hands were performed in seven cadaveric specimens.
The anatomical variants of the superficial palmar arch were recorded, as well as their
relationship with the Kaplan cardinal line. A review of the available literature was
made.
Results According to the classification by Coleman et al, the most common type was the complete
superficial palmar arch, present in seven hands, while the incomplete superficial
palmar arch was found in three hands. The most frequent complete palmar arch was type
IB, followed by type IIB, and finally type IA and type IIA. The most common relation
was with the Kaplan cardinal line type A to the apex of the arch and with type B to
the curvature of the ulnar artery.
Conclusions There is a great anatomical variability in the superficial palmar arch. There was
a greater frequency of the complete superficial palmar arch, with the ulnar artery
being the dominant vascular supply. The Kaplan cardinal line can be used as a safety
limit to avoid the superficial palmar arch if it is drawn to intersect the pisiform
bone.
Clinical Relevance It is important to be aware of the anatomical variants of the superficial palmar
arch, as well as of its relationship with the superficial structures of the hand to
be able to perform invasive or reconstructive procedures and to preserve the vascularity
of the hand.
Keywords
superficial palmar arch - hand - vascularity
