A rare anatomic variation of the superficial palmar branch of the radial artery causing pain.

BACKGROUND: The superficial palmar branch of the radial artery (SPBRA) normally pierces through the thenar muscles and unites with the ulnar artery to form the superficial palmar arch. Rarely, a subcutaneous course of the SPBRA is described in which the artery lies superficial to the thenar muscles.

CASE REPORT: We report about a 17-year-old female patient with pain at the thenar eminence due to a unique course of the SPBRA. Duplex sonography and magnetic resonance angiography revealed a subcutaneous course of the artery over the thenar muscles. Arterial transposition by splitting of the abductor pollicis brevis muscle was performed. At 12-month follow-up, the patient is still free of symptoms. Duplex sonography confirmed patency of the SPBRA.

CONCLUSION: While a subcutaneous course of the SPBRA has been described before, we present an adolescent patient with this anatomical variation causing pain. Our specifically tailored treatment strategy consisting of arterial transposition by splitting of the abductor pollicis brevis muscle was efficient and feasible in our patient and hand surgeons should be aware of this anatomical variation.