Tortuous ulnar artery and Gantzer’s muscle: A rare presentation with clinical implications.

ABSTRACT

The ulnar artery, larger terminal branch of brachial artery is one of the principal arteries contributing to the vascular supply of forearm. It passes through a narrow tunnel, the Guyon’s canal, along with the ulnar nerve at the level of wrist. Ulnar artery is approached during surgical interventions like, coronary and cerebral angiography, ulnar-cephalic arteriovenous fistula etc., in situations where access to radial artery fails. The lesions of ulnar artery such as aneurysms, tortuosity, aberrancy, etc. may lead to entrapment neuropathies of the ulnar nerve. We have reported here a case of tortuous ulnar artery in the distal forearm and hand of the left side of a 62 years old male, which is a rare finding observed during routine educational cadaveric dissection. The tortuosity was observed in the form of twists and bends at various levels in 15cm long segment of ulnar artery in the distal forearm wrist and hand up to the commencement of superficial palmar arch. An aberrant head of flexor pollicis longus was seen crossing the ulnar artery. The ulnar artery of right side was normal and no other anatomical variations were seen. Such muscular variations may simulate soft tissue tumors resulting in nerve or vascular compressions and also influence the biomechanics of wrist and hand. An understanding of variations in the regional anatomy is essential for surgeons, cardiologists and neuroradiologists for preventing failure of surgical procedures.