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The Morphology of Common Interosseous Artery and Its Clinical Scholars Journal of Applied Medical Sciences (SJAMS) ISSN 2320-6691 (Online) Sch. J. App. Med. Sci., 2015; 3(3B):1126-1131 ISSN 2347-954X (Print) ©Scholars Academic and Scientific Publisher (An International Publisher for Academic and Scientific Resources) www.saspublisher.com Research Article The Morphology of Common Interosseous Artery and its Clinical Significance Waseem Al Talalwah1*, Dereje Getachew2 and Roger Soames3 1King Abdullah International Medical Research Center / King Saud bin Abdulaziz University for Health Sciences, College of Medicine, Department of Basic Medical Sciences Hospital – NGHA, Riyadh, P.O. Box 3660, Riyadh 2Anatomy Department, College of Medicine and Health sciences, Hawassa University, Awassa, 1560 3Centre for Anatomy and Human Identification, College of Art, Science and Engineering, University of Dundee Dundee, DD1 5EH, UK *Corresponding author Dr. Waseem Al-Talalwah Abstract: The common interosseous artery is main branch the ulnar artery which divides into anterior and posterior interosseous branches. The current study investigates common interosseous artery and its branch to provide detailed information regarding the morphology which would be of use to clinicians, orthopaedic surgeons, plastic surgeons and anatomists. Routine dissections of the right and left upper limb of 34 adult cadavers (20 male and 14 female: mean age 78.9 year) were undertaken. The common interosseous artery presents in 67.6% whereas it is congenital absence in 32.4%. The origin distance of bifurcation of common interosseous from the ulnar artery origin is between 33.11 and 33.45 mm. The anterior and posterior interosseous arteries present in 98.5% and 92.9% whereas they are congenital absence in 1.5% and 7.1% respectively in total cases. Further, the anterior and posterior interosseous arteries present in 92.9% whereas they are congenital absence in 7.1% in female. The external diameters of the common, anterior and posterior interosseous arteries at their origin ranged from 1.39-1.86 mm, 1.59-1.80 mm and 1.80-1.95 mm respectively. Understanding the variability of common interosseous artery and its branch may help the clinicians and surgeon for clinical use in heart, carotid and flap transplantations. Keywords: Ulnar artery, Common interosseous artery, Posterior interosseous artery, Anterior interosseous artery diameter, Wall thickness. INTRODUCTION distance of bifurcation of the common interosseous The common interosseous artery is a terminal artery from the origin of the ulnar artery as well as the branch the ulnar artery dividing into anterior and internal diameter, external diameter and wall thickness posterior digitorum profundus and flexor pollicis of the anterior and posterior interosseous arteries. With longus, supplying each: perforating branches pierce the a variability of common interosseous artery, there is a interosseous membrane to supply the deep extensor conflict in surgical transplantations which may end with muscles. It also has a small branch, which contributes to iatrogenic fault and failure. the vascular network around the carpal bones and joints. Both radius and ulna receive nutrient vessels. At the MATERIALS AND METHODS level of upper border of pronator quadratus the anterior This study was undertaken in the anatomy interosseous artery passes through the interosseous laboratory of Centre for Anatomy and Human membrane posteriorly. The posterior interosseous artery Identification at the University of Dundee. The supplies the posterior compartment of the forearm, procedures used were in line with approved protocols passing dorsally over the proximal margin of the for the anatomy laboratory of Centre for Anatomy and interosseous artery. The posterior interosseous artery Human Identification. This was dissection-based study vanished near the back of interosseous space proximal of 68 upper limbs (34 rights, 34 left) of 14 adult female to the upper end of the interosseous membrane but and 20 male cadavers (age range 37-96 years) in which distal to the oblique cord [1]. the common interosseous artery and its branches were exposed. The origin level of common interosseous The general objective of this study is to artery from the level of brachial artery bifurcation was understand the morphology of common interosseous taken. Further, the internal and external diameters of the artery. Consequently, it is importance to know the common, anterior and posterior interosseous arteries at internal diameter, external diameter, wall thickness and specified levels were measured using vernier calliper, 1126 Waseem Al Talalwah et al., Sch. J. App. Med. Sci., 2015; 3(3B):1126-1131 ruler and a protractor. The materials used in the 67.6% whereas it is congenital absence in 32.4%. The measurement programme includes vernier calliper to common interosseous artery presents in 50% whereas it measure the internal and external diameter, ruler to is congenital absence in 50% in male and female. The measure the position of the bifurcation of the brachial origin distance of bifurcation of common interosseous artery and length of the common interosseous artery, from the ulnar artery origin is between 33.11 and 33.45 and a protractor to measure the angles of origin. The mm. The anterior and posterior interosseous artery data were collected over a period of three consecutive presents in 98.5% and 92.9% whereas they are months which includes mean and standard deviation.T- congenital absence in 1.5% and 7.1% respectively in tests were performed to assess differences in arterial total cases. Further, the anterior and posterior diameter between females and males and right and left interosseous arteries present in 95% and 92.9% whereas sides, as well as along the length of individual vessels. they are congenital absence in 5% and 7.1% in male In addition, the correlation between different aspects of and female respectively. In investigation of the internal the same vessel or between similar aspects of different and external diameter of common, anterior and vessels was also performed. posterior interosseous arteries, there is a significant (p<0.05) difference between some male and female RESULTS values as well as between the left and right sides (Table The data were collected from both limbs of 34 1). In investigation of the mean, standard deviation and cadavers (14 female and 20 male): the mean male and the range of values of the distance between the female ages were 81±7.2 and 75.9±16.3 respectively. bifurcation of common interosseous artery and the The combined mean age is 78.9 with standard deviation origin of ulnar artery, the male distance is significantly of 11.9 years. The range of ages of all cadavers was 37 (p<0.05) larger than the female value (Table 2). to 96 years. The common interosseous artery presents in Fig. 1: The common interosseous artery is main branch the ulnar artery. B: Brachial artery, U: Ulnar artery, R: Radial artery, C: Common interosseous artery. Fig. 2: Congenital absence of common interosseous artery; B: Brachial artery, U: Ulnar artery, R: Radial artery 1127 Waseem Al Talalwah et al., Sch. J. App. Med. Sci., 2015; 3(3B):1126-1131 Table 1: Means and associated standard deviations (mm) of the external (Ext) and internal (Int) diameters and thickness of the common (CIA), anterior (AIA) and posterior (PIA) interosseous arteries (At) their origin in males and females, as well as for the combined group. Male Left Right Ext Int Thickness Ext Int Thickness Artery Mean (SD) Mean (SD) CIA 2.13(1.20)^ 1.87(1.10)^ 0.13(0.05)* 1.22(1.32) 0.90(1.06) 0.16(0.13) AIA 1.86(0.80)* 1.55(1.19) 0.15(0.01) 2.03(0.54)* 1.74(0.53)* 0.14(0.01) PIA 2.04(0.73)* 1.70(0.68)* 0.17(0.03) 2.07(0.78) 1.69(0.56) 0.19(0.11) Female Mean (SD) Mean (SD) Left Right Ext Int Thickness Ext Int Thickness CIA 1.49(1.25) 1.31(1.10) 0.09(0.07) 1.63(1.13) 1.46(1.07) 0.08(0.03) AIA 1.22(0.59) 0.93(0.56) 0.14(0.01) 1.49(0.36) 1.16(0.40) 0.16 (-0.02) PIA 1.47(0.75) 1.20(0.65) 0.13(0.05) 1.77(0.53) 1.45(0.45) 0.16(0.04) Total Cases Mean (SD) Mean (SD) Left Right Ext Int Thickness Ext Int Thickness CI 1.86(1.24) 1.64(1.12) 0.11(0.06) 1.39(1.24) 1.14(1.08) 0.12(0.08) AI 1.59(0.78) 1.29(0.76) 0.15(0.01) 1.80(0.54) 1.50(0.56) 0.15(-0.01) PI 1.80(0.78) 1.50(0.70) 0.15(0.04) 1.95(0.69) 1.59(0.53) 0.18(0.08) *Significantly (p<0.05) larger than corresponding female value; ^ Significantly (p<0.05) larger than corresponding right side value Table 2: Distance (mm) of the origin of the common interosseous artery from the origin of ulnar artery Male Left Right Mean 34.67 35.57 Standard Deviation 5.55 6.48 Range 24-45 20-45 Female Left Right Mean 31.71 29.6 SD 5.22 7.72 Range 21.66-41 15-42 Total cases Left Right Mean 33.45 33.11 Standard deviation 5.53 7.52 Range 21.66-45 15-45 DISCUSSION artery for surgical intervention and increase rate of The variability of vascular upper limb has been successful with minimize of iatrogenic fault. recorded in series studies and found to be between 9% and 34.7% occurrence rate [2-13]. Embryologically, the The common interosseous artery usually arise axillary, brachial, and interosseous arteries develop from from ulnar artery and splits into anterior and posterior the primitive axial artery [11].
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