Skip to main content
Erschienen in: HAND 2/2010

01.06.2010 | Original Article

The Clinical Application of Kaplan’s Cardinal Line as a Surface Marker for the Superficial Palmar Arch

verfasst von: Anand P. Panchal, Marc A. Trzeciak

Erschienen in: HAND | Ausgabe 2/2010

Einloggen, um Zugang zu erhalten

Abstract

We feel the original description of Kaplan’s cardinal line provides a more accurate reference point to the superficial palmar arterial arch. We sought to anatomically correlate the relationship of Kaplan’s cardinal line to the superficial palmar arch. Sixty hands (30 cadavers) were dissected after Kaplan’s original description was drawn on each hand. Measurements we made from Kaplan’s cardinal line to the superficial palmar arch at both the radial and ulnar borders of the ring finger. The superficial palmar arterial arch was an average of 10.4 and 11.8 mm from the radial and ulnar borders of the ring finger with standard deviations of roughly 4 mm for each measurement. Clinically, Kaplan’s cardinal line is a more predictable landmark for the superficial palmar arch. In referencing this landmark as the distal most extent of an open or endoscopic carpal tunnel release, the superficial palmar arch should be free of transection.
Literatur
1.
Zurück zum Zitat Bilge O, Pinar Y, Ozer MA, et al. A morphometric study on the superficial palmar arch of the hand. Surg Radiol Anat. 2006;28:343–50.CrossRefPubMed Bilge O, Pinar Y, Ozer MA, et al. A morphometric study on the superficial palmar arch of the hand. Surg Radiol Anat. 2006;28:343–50.CrossRefPubMed
2.
Zurück zum Zitat Brown RA, Gelberman RH. Carpal tunnel release: open technique. In: Blair W, editor. Techniques in hand surgery. Philadelphia: Williams & Wilkins; 1996. p. 703–10. Brown RA, Gelberman RH. Carpal tunnel release: open technique. In: Blair W, editor. Techniques in hand surgery. Philadelphia: Williams & Wilkins; 1996. p. 703–10.
3.
Zurück zum Zitat Chow JCY. Endoscopic release of the carpal ligament. A new technique for carpal tunnel syndrome. Arthropscopy. 1989;5:19–24. Chow JCY. Endoscopic release of the carpal ligament. A new technique for carpal tunnel syndrome. Arthropscopy. 1989;5:19–24.
4.
Zurück zum Zitat Cobb TK, Knudson GA, Cooney WP. The use of topographical landmarks to improve the outcome of Agee endoscopic carpal tunnel release. Arthroscopy. 1995;11(2):165–72.PubMed Cobb TK, Knudson GA, Cooney WP. The use of topographical landmarks to improve the outcome of Agee endoscopic carpal tunnel release. Arthroscopy. 1995;11(2):165–72.PubMed
5.
Zurück zum Zitat Coleman SS, Anson BJ. Arterial patterns in the hand based upon a study of 650 specimens. Surg Gynecol Obstet. 1961;113:409–42.PubMed Coleman SS, Anson BJ. Arterial patterns in the hand based upon a study of 650 specimens. Surg Gynecol Obstet. 1961;113:409–42.PubMed
6.
Zurück zum Zitat Gellman H, Botte MJ, Shankwiler J, et al. Arterial pattern of the deep and superficial palmar arches. Clin Orthop Relat Res. 2001;383:41–6.CrossRefPubMed Gellman H, Botte MJ, Shankwiler J, et al. Arterial pattern of the deep and superficial palmar arches. Clin Orthop Relat Res. 2001;383:41–6.CrossRefPubMed
7.
Zurück zum Zitat Hoppenfeld S, DeBoer P. The wrist and hand. Surgical Exposures in orthopaedics: the anatomic approach. 2nd ed. Philadelphia: J.B. Lippincott Co; 1994. p. 147–214. Hoppenfeld S, DeBoer P. The wrist and hand. Surgical Exposures in orthopaedics: the anatomic approach. 2nd ed. Philadelphia: J.B. Lippincott Co; 1994. p. 147–214.
8.
Zurück zum Zitat Jelecic N, Gajisin S, Zbrodowski A. Arcus palmaris superficialis. Acta Anat. 1988;132:187–90. Jelecic N, Gajisin S, Zbrodowski A. Arcus palmaris superficialis. Acta Anat. 1988;132:187–90.
9.
Zurück zum Zitat Kaplan EB. Surface anatomy of the hand and wrist. In: Spinner E, editor. Functional and surgical anatomy of the hand. Philadelphia: J.B. Lippincott Co; 1953. p. 227–31. Kaplan EB. Surface anatomy of the hand and wrist. In: Spinner E, editor. Functional and surgical anatomy of the hand. Philadelphia: J.B. Lippincott Co; 1953. p. 227–31.
10.
Zurück zum Zitat Kaplan EB. Approach to the upper extremity. Surgical approaches to the neck, cervical spine, and upper extremity. Philadelphia: W.B. Saunders Co; 1966. p. 143–60. Kaplan EB. Approach to the upper extremity. Surgical approaches to the neck, cervical spine, and upper extremity. Philadelphia: W.B. Saunders Co; 1966. p. 143–60.
11.
Zurück zum Zitat Kaplan EB. Guide lines to deep structures and dynamics of intrinsic muscles of the hand. Surg Clin North Am. 1968;48:993–1002.PubMed Kaplan EB. Guide lines to deep structures and dynamics of intrinsic muscles of the hand. Surg Clin North Am. 1968;48:993–1002.PubMed
12.
Zurück zum Zitat Lee DH, Masear VR, Meyer RD, et al. Endoscopic carpal tunnel release: a cadaveric study. J Hand Surg. 1992;17A:1003–8. Lee DH, Masear VR, Meyer RD, et al. Endoscopic carpal tunnel release: a cadaveric study. J Hand Surg. 1992;17A:1003–8.
13.
Zurück zum Zitat Lee WPA, Strickland JW. Safe carpal tunnel release via a limited palmar incision. Plast Reconstr Surg. 1998;101(2):418–24.CrossRefPubMed Lee WPA, Strickland JW. Safe carpal tunnel release via a limited palmar incision. Plast Reconstr Surg. 1998;101(2):418–24.CrossRefPubMed
14.
Zurück zum Zitat Levy HJ, Soifer TB, Kleinbart FA, et al. Endoscopic carpal tunnel release: an anatomic study. Arthroscopy. 1993;9(1):1–4.PubMed Levy HJ, Soifer TB, Kleinbart FA, et al. Endoscopic carpal tunnel release: an anatomic study. Arthroscopy. 1993;9(1):1–4.PubMed
15.
Zurück zum Zitat Mclean KM, Sacks JM, Kuo YR, et al. Anatomical Landmarks to the superficial and deep palmar arches. Plast Reconstr Surg. 2008;121:181–5.CrossRefPubMed Mclean KM, Sacks JM, Kuo YR, et al. Anatomical Landmarks to the superficial and deep palmar arches. Plast Reconstr Surg. 2008;121:181–5.CrossRefPubMed
16.
Zurück zum Zitat Najile DJ, Fisher TJ, Harris GD. A multicenter prospective review of 640 endoscopic carpal tunnel releases using the transbursal and extrabursal Chow techniques. Arthroscopy. 1996;10:239. Najile DJ, Fisher TJ, Harris GD. A multicenter prospective review of 640 endoscopic carpal tunnel releases using the transbursal and extrabursal Chow techniques. Arthroscopy. 1996;10:239.
17.
Zurück zum Zitat Omokawa S, Tanaka Y, Ryu J, et al. Anatomy of the ulnar artery as it relates to the transverse carpal ligament. J Hand Surg. 2002;27A:101–4. Omokawa S, Tanaka Y, Ryu J, et al. Anatomy of the ulnar artery as it relates to the transverse carpal ligament. J Hand Surg. 2002;27A:101–4.
18.
Zurück zum Zitat Palmer AK, Tolvonen DA. Complications of endoscopic and open carpal tunnel release. J Hand Surg. 1999;24A:561–5. Palmer AK, Tolvonen DA. Complications of endoscopic and open carpal tunnel release. J Hand Surg. 1999;24A:561–5.
19.
Zurück zum Zitat Riordan DC, Kaplan EB. Surface anatomy of the hand and wrist. In: Spinner M, editor. Kaplan’s functional and surgical anatomy of the hand. 3rd ed. Philadelphia: J.B. Lippincott Co; 1984. p. 353–60. Riordan DC, Kaplan EB. Surface anatomy of the hand and wrist. In: Spinner M, editor. Kaplan’s functional and surgical anatomy of the hand. 3rd ed. Philadelphia: J.B. Lippincott Co; 1984. p. 353–60.
20.
Zurück zum Zitat Rotman MB, Manske PR. Anatomic relationships of an endoscopic carpal tunnel device to surrounding structures. J Hand Surg. 1993;18A:442–50. Rotman MB, Manske PR. Anatomic relationships of an endoscopic carpal tunnel device to surrounding structures. J Hand Surg. 1993;18A:442–50.
21.
Zurück zum Zitat Rowland E, Kleinert JM. Endoscopic carpal tunnel release in cadavers: an investigation of the results of twelve surgeons with this training model. J Bone Joint Surg. 1994;76A:266–8. Rowland E, Kleinert JM. Endoscopic carpal tunnel release in cadavers: an investigation of the results of twelve surgeons with this training model. J Bone Joint Surg. 1994;76A:266–8.
22.
Zurück zum Zitat Sacks JM, Kuo YR, Mclean K, et al. Anatomical relationships among the median nerve thenar branch, superficial palmar arch, and transverse carpal ligament. Plast Reconstr Surg. 2007;120(3):713–8.CrossRefPubMed Sacks JM, Kuo YR, Mclean K, et al. Anatomical relationships among the median nerve thenar branch, superficial palmar arch, and transverse carpal ligament. Plast Reconstr Surg. 2007;120(3):713–8.CrossRefPubMed
23.
Zurück zum Zitat Seiler JG, Barnes K, Gelberman RH, et al. Endoscopic carpal tunnel release: an anatomic study of the tow-incision technique in human cadavers. J Hand Surg. 1992;17A:996. Seiler JG, Barnes K, Gelberman RH, et al. Endoscopic carpal tunnel release: an anatomic study of the tow-incision technique in human cadavers. J Hand Surg. 1992;17A:996.
24.
Zurück zum Zitat Tsuruta T, Syed SA, Tsai T. Comparison of proximal and distal one portal entry techniques for endoscopic carpal tunnel release. J Hand Surg. 1994;19B:618–21. Tsuruta T, Syed SA, Tsai T. Comparison of proximal and distal one portal entry techniques for endoscopic carpal tunnel release. J Hand Surg. 1994;19B:618–21.
25.
Zurück zum Zitat Vasiliadis HS, Tokis AV, Andrikoula SI, et al. Microsurgical dissection of the carpal tunnel with respect to neurovascular structures at risk during endoscopic carpal tunnel release. Arthroscopy. 2006;22(8):807–12.PubMedCrossRef Vasiliadis HS, Tokis AV, Andrikoula SI, et al. Microsurgical dissection of the carpal tunnel with respect to neurovascular structures at risk during endoscopic carpal tunnel release. Arthroscopy. 2006;22(8):807–12.PubMedCrossRef
26.
Zurück zum Zitat Vella JC, Hartigan BJ, Stern PJ. Kaplan’s cardinal line. J Hand Surg. 2006;31(A):912–8. Vella JC, Hartigan BJ, Stern PJ. Kaplan’s cardinal line. J Hand Surg. 2006;31(A):912–8.
Metadaten
Titel
The Clinical Application of Kaplan’s Cardinal Line as a Surface Marker for the Superficial Palmar Arch
verfasst von
Anand P. Panchal
Marc A. Trzeciak
Publikationsdatum
01.06.2010
Verlag
Springer-Verlag
Erschienen in
HAND / Ausgabe 2/2010
Print ISSN: 1558-9447
Elektronische ISSN: 1558-9455
DOI
https://doi.org/10.1007/s11552-009-9229-0

Weitere Artikel der Ausgabe 2/2010

HAND 2/2010 Zur Ausgabe

Update Chirurgie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

S3-Leitlinie „Diagnostik und Therapie des Karpaltunnelsyndroms“

CME: 2 Punkte

Prof. Dr. med. Gregor Antoniadis Das Karpaltunnelsyndrom ist die häufigste Kompressionsneuropathie peripherer Nerven. Obwohl die Anamnese mit dem nächtlichen Einschlafen der Hand (Brachialgia parästhetica nocturna) sehr typisch ist, ist eine klinisch-neurologische Untersuchung und Elektroneurografie in manchen Fällen auch eine Neurosonografie erforderlich. Im Anfangsstadium sind konservative Maßnahmen (Handgelenksschiene, Ergotherapie) empfehlenswert. Bei nicht Ansprechen der konservativen Therapie oder Auftreten von neurologischen Ausfällen ist eine Dekompression des N. medianus am Karpaltunnel indiziert.

Prof. Dr. med. Gregor Antoniadis
Berufsverband der Deutschen Chirurgie e.V.

S2e-Leitlinie „Distale Radiusfraktur“

CME: 2 Punkte

Dr. med. Benjamin Meyknecht, PD Dr. med. Oliver Pieske Das Webinar S2e-Leitlinie „Distale Radiusfraktur“ beschäftigt sich mit Fragen und Antworten zu Diagnostik und Klassifikation sowie Möglichkeiten des Ausschlusses von Zusatzverletzungen. Die Referenten erläutern, welche Frakturen konservativ behandelt werden können und wie. Das Webinar beantwortet die Frage nach aktuellen operativen Therapiekonzepten: Welcher Zugang, welches Osteosynthesematerial? Auf was muss bei der Nachbehandlung der distalen Radiusfraktur geachtet werden?

PD Dr. med. Oliver Pieske
Dr. med. Benjamin Meyknecht
Berufsverband der Deutschen Chirurgie e.V.

S1-Leitlinie „Empfehlungen zur Therapie der akuten Appendizitis bei Erwachsenen“

CME: 2 Punkte

Dr. med. Mihailo Andric
Inhalte des Webinars zur S1-Leitlinie „Empfehlungen zur Therapie der akuten Appendizitis bei Erwachsenen“ sind die Darstellung des Projektes und des Erstellungswegs zur S1-Leitlinie, die Erläuterung der klinischen Relevanz der Klassifikation EAES 2015, die wissenschaftliche Begründung der wichtigsten Empfehlungen und die Darstellung stadiengerechter Therapieoptionen.

Dr. med. Mihailo Andric
Berufsverband der Deutschen Chirurgie e.V.