The palmar metacarpal arteries arise from the deep palmar arch and run distally on the interosseous muscles to anastomose with the common palmar digital arteries from the superficial arch at the level of the metacarpal heads. They supplement the digital artery supply to the fingers and are the basis for reverse metacarpal artery flaps.
The palmar metacarpal arteries are the pedicles for reverse-flow metacarpal artery island flaps used for finger tip and proximal phalanx reconstruction. The second palmar metacarpal artery is the most reliable and largest. Their anastomosis with the digital arteries at the web space is the basis of web space and dorsal digital flaps. Injury to the palmar metacarpal arteries in metacarpal fractures may contribute to digital ischaemia in crush injuries.
Disruption of palmar metacarpal arteries in metacarpal shaft fractures or penetrating palm injuries, potentially compromising digital perfusion via the deep arch contribution to the digital arteries.
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