Persistent median artery of the forearm and palm: a cadaver study into its origin, course, fate and clinical significance

The median artery is the axis artery of forearm till the 8th week of gestation and thereafter normally regresses, only its proximal part remaining patent as the companion artery of the median nerve in adults. A large, well developed persistent median artery extended to the palm and contributed to its vascular supply in 6 out of 100 upper limbs dissected. Dissection was used to demonstrate the persistent median arteries from their origin to termination. The persistent median artery originated from the ulnar artery in the cubital fossa. It pierced the median nerve, descended anterior to the nerve in a common sheath and passed deep to the flexor retinaculum. An accessory head of flexor pollicis longus, which is a usual finding associated with the persistent median artery, was seen in one forearm. The superficial palmar arch was not seen in any specimen with persistent median artery. In all the specimens with persistent median artery, the lateral half of the palm and lateral 2½ digits were supplied by it, whereas the medial half of palm and the medial 2 ½ digits were supplied by the ulnar artery. The persistent median artery may contribute to median nerve compression neuropathy. The variations in the vascular supply of hand have clinical implications.