The proper palmar digital arteries are the terminal branches of the common palmar digital arteries, running along the medial and lateral borders of each finger to supply the finger skin, subcutaneous tissue, nail bed, and distal phalanx. Each finger has a radial and ulnar proper digital artery forming a dual axial supply. The dominant supply typically alternates — the thumb is supplied dominantly by the princeps pollicis from the radial artery.
The proper palmar digital arteries are the critical vessels in finger replantation: after amputation, the radial and ulnar digital arteries are individually repaired under the operating microscope to restore perfusion. Arterial repair takes priority over vein repair in digital replantation, as arterial inflow is the primary determinant of replant survival. Digital artery anatomy — identifying the proper digital artery in the neurovascular bundle (medial to the digital nerve on the dorsal view, lateral on the palmar view) — guides digital nerve block injection and surgical approach. Single digital artery injury may be tolerated if the contralateral digital artery remains intact.
Digital replantation requires microsurgical repair of both radial and ulnar proper palmar digital arteries (0.5-1 mm diameter) using 9-0 or 10-0 interrupted monofilament sutures under 10-40x magnification; successful arterial anastomosis restores pink colour and fingertip turgor within minutes of clamp release.
