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studies have statistically analyzed the absence of the ulnar
artery, the absence of the ulnar artery, its incidence may
be considered < 0.015%. Comparative anatomy studies
[5]
suggest a theory of evolution underlying this anomaly. [9,10]
These studies state that complete or partial absence of
the ulnar artery might be the transition form from its
total absence which can be seen in some lower animals to
its complete development in humans.
a b
Figure 1: Arteriography of the hands showing the absence of the
distal ulnar arteries and superficial palmar arches. Deep palmar REFERENCES
arches are shown without any contribution from the ulnar artery
(arrow) (a: right hand, b: left hand) 1. Mccormack LJ, Cauldwell EW, Anson BJ. Brachial and antebrachial arterial
patterns: a study of 750 extremities. Surg Gynecol Obstet 1953;96:43‑54.
palmar arch has different types of anastomosis: (a) the 2. Coleman SS, Anson BJ. Arterial patterns in the hand based upon a study of
“ulnar type” has minimal or absent flow from radial 3. 650 specimens. Surg Gynecol Obstet 1961;113:409‑24.
Keen JA. A study of the arterial variations in the limbs, with special reference
artery; (b) the “radio‑ulnar type” is the arch is formed to symmetry of vascular patterns. Am J Anat 1961;108:245‑61.
by the superficial palmar branch of radial artery and 4. Adachi B, Hasebe K, Daigaku K. The arterial system of the Japanese. Kyoto:
the larger ulnar artery; and (c) the “mediano‑ulnar type” Kaiserlich‑Japanische Universität zu Kyoto; 1928. p. 365‑8.
has predominant supply from median artery as it is able 5. Rodríguez‑Niedenführ M, Vázquez T, Nearn L, Ferreira B, Parkin I, Sañudo JR.
Variations of the arterial pattern in the upper limb revisited: a morphological
to reach the palm of the hand and forms the arch. It is and statistical study, with a review of the literature. J Anat 2001;199:547‑66.
reported that “ulnar type” is the most frequent (59%) 6. Botte MJ, Doyle JR. Surgical Anatomy of the Hand and Upper Extremity.
and is followed by the “radio‑ulnar type” (32%), and the Philadelpia: Lippincott Williams and Wilkins; 2003. p. 263.
“mediano‑ulnar type” is the least common (9%). An arch 7. Al‑Turk M, Metcalf WK. A study of the superficial palmar arteries using the
[4]
Doppler Ultrasonic Flowmeter. J Anat 1984;138:27‑32.
is considered incomplete when there are no continuations 8. Varley I, Carter LM, Wales CJ, Warnock N, Whitfield PH. Ischaemia of the hand
among the ulnar, radial, and median arteries. This after harvest of a radial forearm flap. Br J Oral Maxillofac Surg 2008;46:403‑5.
[7]
explains ischemic complications in the hand after 9. Schwalbe E. Comparative anatomy of the forearm arteries, specially the Arcus
volaris sublimis. Gegenbaurs Morphol Jahrb 1895;23:412‑51.
harvesting of radial forearm flaps, because in patients 10. Zuckerkandl E. The anatomy and evolution of the arteries of the forearm.
with incomplete palmar arches, blood flow from the ulnar Anat Hefte 1894;4:1‑98.
artery cannot reach the radial fingers. [8]
The absence of the ulnar artery is an extremely rare How to cite this article: Lee JH, Ju RK, Jun YJ, Kim YJ. A rare case of
anomaly. Coleman and Anson studied 650 cadaveric bilateral absence of distal ulnar artery. Plast Aesthet Res 2015;2:79-80.
[2]
dissections and found no cases of a complete absence of Source of Support: Nil, Conflict of Interest: None declared.
the ulnar artery in the hand. Although several large‑sample Received: 15-08-2014; Accepted: 03-11-2014

80 Plast Aesthet Res || Vol 2 || Issue 2 || Mar 13, 2015