Background: Vascular studies of the thumb have reported conflicting results; even the anatomical nomenclature differs between studies. The main purpose of this study was to describe the local patterns of thumb vascular anatomy.
Methods: The authors studied 30 fresh right hands from male and female cadavers using a vascular injection technique with methyl methacrylate. The origins, course, and characteristics of the arteries of the thumb are described.
Results: The princeps pollicis artery was present in all of the hands and was the origin of the radial and ulnar digital arteries in 73.3 percent. The radial and ulnar digital arteries originated from the princeps pollicis artery or branches of the palmar metacarpal artery in 53.3 and 83.3 percent of the dissections, respectively. Dorsally, the dorsal ulnar artery was present in 100 percent of the hands and originated mainly from the princeps pollicis artery (73.3 percent). The dorsal radial artery was present in 66.7 percent of dissections as a direct branch of the radial artery. Several anastomoses were observed between the radial and ulnar digital arteries and between the dorsal and palmar systems.
Conclusions: Various arterial systems were described in the arterial irrigations of the thumb, such as the dorsopalmar and radioulnar. The complex configuration and the multiple anastomotic arcades between the arterial systems allow the thumb to survive even after severe lesions of nearly all of the arteries. The presence of these interconnected systems provides multiple alternatives in flap design without endangering their survival.