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Palmar Carpal Arch

arcus carpalis palmaris

The palmar carpal arch is a small arterial network across the front of the wrist, formed by the palmar carpal branches of the radial and ulnar arteries. It lies deep to the flexor tendons at the level of the distal radius and the carpal bones. Branches from the anterior interosseous artery and recurrent branches from the deep palmar arch often join it.

Anatomical Data

Course & Branches

Origin	Palmar carpal branches of the radial and ulnar arteries at the distal border of pronator quadratus
Course	Runs transversely across the front of the distal radius and carpus, deep to the flexor tendons
Branches	Branches to the distal radius and ulna Branches to the carpal bones and wrist joint Anastomoses with the anterior interosseous artery and the deep palmar arch

Clinical Relevance

Clinical Notes

The palmar carpal arch, together with the dorsal carpal arch, supplies the carpal bones, which have a limited and in places one-directional blood supply. This is clinically important for the scaphoid and lunate, which can lose their blood supply after fractures or in Kienbock disease. Vessels of the arch may also be encountered during volar plating of distal radius fractures and in carpal surgery.

Pathology

Common Injuries & Conditions

Avascular Necrosis of the Lunate (Kienbock Disease)

Interruption or poor development of the blood supply to the lunate from the palmar and dorsal carpal arches leads to collapse of the bone, causing wrist pain, stiffness and weak grip.

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