Surgical and Radiologic Anatomy

, Volume 41, Issue 11, pp 1325–1332 | Cite as

Branches of ulnar artery in human fetuses: anatomical and morphometric study

  • Selda Yildiz
  • Necdet Kocabiyik
  • Ozlem Elvan
  • Bulent Yalcin
  • Ayhan ComertEmail author
Original Article



This study was conducted to demonstrate morphological pattern of the ulnar artery and to evaluate morphometrically its anatomical branching pattern in human fetuses.


Branching pattern of ulnar artery was evaluated on 121 upper limbs of dissected 63 of formalin-fixed fetus cadavers with gestational age ranging from 17 to 40 weeks. In order to obtain second and third trimester data, according to their gestational age, two groups were determined.


In 79 of all 121 upper limbs (65%) ulnar artery gave anterior and posterior ulnar recurrent arteries as separate branches. In this study frequency of presence of a median artery was 46.28% among total examined 121 upper limbs. Median arteries originated from ulnar artery (3.57%) and from the common interosseous artery (53.57%) and anterior interosseous artery (42.85%). Mean distances of the measured parameters were demonstrated according to the gestational age and differences between group I (second trimester) and group II (third trimester). No statistical difference for groups was observed for gender and between right and left sides.


Ulnar artery shows predictable patterns during second and third trimester of fetal period and can be suitable access effective alternative for diagnostic and therapeutic coronary interventions. Persistent median artery is important variation and knowledge of its incidence is important for diagnostic difficulties and also during awareness of its injury during surgical approaches.


Ulnar artery Branching pattern Anatomy Fetus Median artery 



This work was not supported by grant funding.

Author contributions

SY, NK, AC designed this study; SY, OE and AC performed anatomical dissections; NK and BY analyzed the data; SY and AC wrote the manuscript.

Compliance with ethical standards

Conflict of interest

None of the authors have any conflict of interest with the content of this manuscript.




  1. 1.
    Adachi B (1928) Das arteriensystem der Japaner. Maruzen, Kyoto, pp 348–356Google Scholar
  2. 2.
    Ahn DS, Yoon ES, Koo SH, Park SH (2000) A prospective study of the anatomic variations of the median nerve in the carpal tunnel in Asians. Ann Plast Surg 44:282–287PubMedCrossRefPubMedCentralGoogle Scholar
  3. 3.
    Aragão JA, da Silva AC, Anunciação CB, Reis FP (2017) Median artery of the forearm in human fetuses in northeastern Brazil: anatomical study and review of the literature. Anat Sci Int 92:107–111PubMedCrossRefPubMedCentralGoogle Scholar
  4. 4.
    Bergman RA, Afifi AK, Miyauchi R (1992–2004) Opus II: cardiovascular system: arteries: upper limb, In: Illustrated encyclopedia of human anatomic variation. Accessed 7 May 2018
  5. 5.
    Bergman RA, Thompson SA, Afifi AK, Saadeh FA (1988) Compendium of human anatomic variation. Urban & Schwarzenberg, Baltimore, pp 72–75Google Scholar
  6. 6.
    Christie DR, Duncan GM, Glasson DW (1994) The ulnar artery free flap: the first 7 years. Plast Reconstr Surg 93:547–551PubMedCrossRefPubMedCentralGoogle Scholar
  7. 7.
    Claassen H, Schmitt O, Wree A (2008) Large patent median arteries and their relation to the superficial palmar arch with respect to history, size consideration and clinic consequences. Surg Radiol Anat 30:57–63PubMedCrossRefPubMedCentralGoogle Scholar
  8. 8.
    Constantino ER, de Paula RC, Rodrigues MR, Fernandes RM (2009) Artéria mediana persistente: abordagem anatômica e implicações clinicas. Acta Sci Med 2:58–63Google Scholar
  9. 9.
    D’Costa S, Narayana K, Narayan P, Nayak SR, Madhan SJ (2006) Occurrence and fate of palmar type of median artery. ANZ J Surg 76:484–487PubMedCrossRefPubMedCentralGoogle Scholar
  10. 10.
    Federative Committee of Anatomical Terminology (FCAT) (1998) Terminologia anatomica. Thieme Verlag, StuttgartGoogle Scholar
  11. 11.
    George BJ, Henneberg M (1996) High frequency of the median artery of the forearm in South African newborns and infants. S Afr Med J 86:175–176PubMedPubMedCentralGoogle Scholar
  12. 12.
    Gokhroo R, Bisht D, Padmanabhan D, Gupta S, Kishor K, Ranwa B (2015) Feasibility of ulnar artery for cardiac catheterization: AJmer ULnar ARtery (AJULAR) catheterization study. Catheter Cardiovasc Interv 86:42–48PubMedCrossRefPubMedCentralGoogle Scholar
  13. 13.
    Guimberteau JC, Goin JL, Panconi B, Schuhmacher B (1988) The reverse ulnar artery forearm island flap in hand surgery: 54 cases. Plast Reconstr Surg 81:925–932PubMedCrossRefPubMedCentralGoogle Scholar
  14. 14.
    Haerle M, Häfner HM, Dietz K, Schaller HE, Brunelli F (2003) Vascular dominance in the forearm. Plast Reconstr Surg 111:1891–1898PubMedCrossRefPubMedCentralGoogle Scholar
  15. 15.
    Hayashi A, Maruyama Y, Saze M, Okada E (2004) Ulnar recurrent adipofascial flap for reconstruction of massive defects around the elbow and forearm. Br J Plast Surg 57:632–637PubMedCrossRefPubMedCentralGoogle Scholar
  16. 16.
    Hazlett JW (1949) The superficial ulnar artery with reference to accidental intra-arterial injection. Can Med Assoc J 61:289–293PubMedPubMedCentralGoogle Scholar
  17. 17.
    Henneberg M, George BJ (1995) Possible secular trend in the incidence of an anatomical variant: median artery of the forarm. Am J Phys Anthropol 96:329–334PubMedCrossRefPubMedCentralGoogle Scholar
  18. 18.
    Henneberg M, George BJ (1996) High frequency of the median artery of the forearm in South African newborns and infants. S Afr Med J 86:175–176PubMedPubMedCentralGoogle Scholar
  19. 19.
    Hubmer MG, Fasching T, Haas F, Koch H, Schwarzl F, Weiglein A, Scharnagl E (2004) The posterior interosseous artery in the distal part of the forearm. Is the term “recurrent branch of the anterior interosseous artery” justified? Br J Plast Surg 57:638–644PubMedCrossRefGoogle Scholar
  20. 20.
    Jones NF, Ming NL (1988) Persistent median artery as a cause of pronator syndrome. J Hand Surg Am 13:728–732PubMedCrossRefPubMedCentralGoogle Scholar
  21. 21.
    Kopuz C, Baris S, Gulman B (1997) A further morphological study of the persistent median artery in the neonatal cadavers. Surg Radiol Anat 19:403–406PubMedCrossRefPubMedCentralGoogle Scholar
  22. 22.
    Kopuz C, Gulman B, Baris S (1995) Persistent median artery: an anatomical study in neonatal and adult cadavers. Kaibogaku Zasshi 70:577–580PubMedPubMedCentralGoogle Scholar
  23. 23.
    Lippert H, Pabst R (1985) Arterial variations in man. Classification and frequency. JF Bergmann Verlag, Munchen, pp 69–73CrossRefGoogle Scholar
  24. 24.
    Lovie MJ, Duncan GM, Glasson DW (1984) The ulnar artery forearm free flap. Br J Plast Surg 37:486–492PubMedCrossRefPubMedCentralGoogle Scholar
  25. 25.
    Maher WP (1990) Palmar-digital arterial networks in fifty pairs of human fetal hands: arteriographic models for clinical considerations. Am J Anat 187:201–210PubMedCrossRefPubMedCentralGoogle Scholar
  26. 26.
    McCormack LJ, Claudwell EW, Anson BJ (1953) Brachial and anterbrachial arterial patterns. A study of 750 extremities. Surg Gynecol Obstet 96:43–54PubMedPubMedCentralGoogle Scholar
  27. 27.
    Moore KL (1992) Clinically oriented anatomy, 3rd edn. Lippincott Williams & Wilkins, Baltimore, p 751Google Scholar
  28. 28.
    Natsis K, Papadopoulou AL, Paraskevas G, Totlis T, Tsikaras P (2006) High origin of a superficial ulnar artery arising from the axillary artery: anatomy, embryology, clinical significance and a review of the literature. Folia Morphol 65:400–405Google Scholar
  29. 29.
    Nunoo-Mensah J (1998) An unexpected complication after harvesting of the radial artery for coronary artery bypass grafting. Ann Thorac Surg 66:929–931PubMedCrossRefPubMedCentralGoogle Scholar
  30. 30.
    Prantl L, Schreml S, Schwarze H, Eisenmann-Klein M, Nerlich M, Angele P, Jung M, Füchtmeier B (2008) A safe and simple technique using the distal pedicled reversed upper arm flap to cover large elbow defects. J Plast Reconstr Aesthet Surg 61:546–551PubMedCrossRefPubMedCentralGoogle Scholar
  31. 31.
    Roberts EB, Palmer N, Perry RA (2007) Transulnar access for coronary angiography and intervention: an early review to guide research and clinical practice. J Invasive Cardiol 19:83–87PubMedPubMedCentralGoogle Scholar
  32. 32.
    Rodriguez-Niedenführ M, Burton GJ, Deu J, Sañudo JR (2001) Development of the arterial pattern in the upper limb of staged human embryos: normal development and anatomic variations. J Anat 199(Pt 4):407–417PubMedPubMedCentralCrossRefGoogle Scholar
  33. 33.
    Rodriguez-Niedenführ M, Sañudo JR, Vazquez T, Logan B, Nearn L, Parkin I (1999) Median artery revisited. J Anat 195:57–63PubMedPubMedCentralCrossRefGoogle Scholar
  34. 34.
    Rodríguez-Niedenführ M, Vázquez T, Nearn L, Ferreira B, Parkin I, Sañudo JR (2001) Variations of the arterial pattern in the upper limb revisited: a morphological and statistical study, with a review of the literature. J Anat 199(Pt 5):547–566PubMedPubMedCentralCrossRefGoogle Scholar
  35. 35.
    Rodriguez-Niedenführ M, Vazquez T, Parkin IG, Sañudo JR (2003) Arterial patterns of the human upper limb: update of anatomical variations and embryological development. Eur J Anat Suppl 7:21–28Google Scholar
  36. 36.
    Singer E (1933) Embryological pattern persisting in the arteries of the arm. Anat Rec 55:403–409CrossRefGoogle Scholar
  37. 37.
    Sieg P, Jacobsen HC, Hakım SG, Hermes D (2006) Superficial ulnar artery: curse or blessing in harvesting fasciocutaneous forearm flaps. Head Neck 28:447–452PubMedCrossRefPubMedCentralGoogle Scholar
  38. 38.
    Standring S (2008) Gray’s anatomy: the anatomical basis of clinical practice, 40th edn. Elsevier Saunders, Philadelphia, p 835 (Chap. 48) Google Scholar
  39. 39.
    Thoma A, Young JEM (1992) The superficial ulnar artery “trap” and the free forearm flap. Ann Plast Surg 28:370–372PubMedCrossRefPubMedCentralGoogle Scholar
  40. 40.
    Varley I, Wales CJ, Carter LM (2008) The median artery: its potential implications for the radial forearm flap. J Plast Reconstr Aesthet Surg 61:693–695PubMedCrossRefPubMedCentralGoogle Scholar
  41. 41.
    Vollala VR, Jetti R, Soni S (2011) High origin of an ulnar artery–development and surgical significance. Chang Gung Med J 34:39–42PubMedPubMedCentralGoogle Scholar
  42. 42.
    Yildiz S, Kocabiyik N, Ozer CM (2014) Variations associated with high division of the superficial brachial artery. Int J Anat Var 7:45–47Google Scholar

Copyright information

© Springer-Verlag France SAS, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of Anatomy, Gulhane Medical FacultyUniversity of Health SciencesAnkaraTurkey
  2. 2.School of HealthMersin UniversityMersinTurkey
  3. 3.Department of AnatomyAnkara University Faculty of MedicineAnkaraTurkey

Personalised recommendations