The princeps pollicis is the primary thumb blood supply, arising from the radial artery as it crosses the deep palm, providing both palmar digital arteries to the thumb. Its reliable origin from the radial artery makes it the basis for the first web space island flap for thumb tip reconstruction. Thumb replantation requires anastomosis of this artery or its digital branches.
| Origin | Radial artery as it crosses the deep palm through the first dorsal web space |
|---|
Thumb tip injuries requiring flap coverage use the first web space or homodigital island flap based on the princeps pollicis. In thumb replantation, the princeps pollicis provides the inflow vessel — anastomosis at the metacarpal level is preferred over the phalangeal level for reliability.
Princeps pollicis artery provides the primary inflow for thumb replantation — anastomosis at the metacarpal level ensures adequate thumb perfusion.
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