Anomaly of the Radial Artery Encountered During the Excision of Wrist Ganglion: A Case Report

손목 결절종제거술 시 경험한 요골동맥 기형의 치험례

  • Kim, Chul-Han (Department of Plastic and Reconstructive Surgery, College of Medicine, Soonchunhyang University) ;
  • Song, Woo-Jin (Department of Plastic and Reconstructive Surgery, College of Medicine, Soonchunhyang University)
  • 김철한 (순천향대학교 의과대학 성형외과학교실) ;
  • 송우진 (순천향대학교 의과대학 성형외과학교실)
  • Received : 2010.08.03
  • Accepted : 2010.09.03
  • Published : 2011.01.10

Abstract

Purpose: An extensive knowledge of the arterial anatomy of the upper extremity and its variations is indispensable to the hand surgeon. We report a patient with anomalous radial artery, superficial course of two radial arteries, encountered during the excision of volar wrist ganglion. Methods: The patient was a 53-year-old man who had a painful mass on the left volar wrist for 1 year. Under general anesthesia, a curved incision was made around the mass. With the skin flaps retracted, the dome of the cyst was identified. Particular care was taken to identify and protect the radial artery, which was intimately attached to the wall of the ganglion. Two radial arteries completely encircled the ganglion. The pedicle was traced to the volar joint capsule, radiocarpal ligament. The joint was open and the capsular attachments were excised. Results: The patient made an uneventful recovery. There were two arterial pulsations at the volar side of the wrist joint. Compressing this site revealed that the major arterial contributor to blood supply in the hand was the ulnar artery. At angioCT, an anomaly of the radial artery was found with a duplication. The pathway of this aberrant artery was superficial to the original radial artery. It changed its course subcutaneously at the level of the tendon of the brachioradialis muscle, and crossing the wrist lateral to the original radial artery and ending in the deep palmar arch. Conclusion: Authors experienced a case of bifurcating radial artery encountered during the excision of ganglion on the volar of the wrist. Because these duplicated radial arteries make strong contributions to the thumb and index finger as well as to the deep palmar arch, when they are present there may be probably less blood supply to the hand from the ulnar artery. If the radial artery is palpated superficially on the brachioradialis muscle, it is important to remember the kind of anomaly.

Keywords

References

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