VASCULARISATION ARTERIELLE DE LA MAIN : ETUDE ANGIOSCANNER, VARIATIONS ANATOMIQUES ET APPLICATIONS CHIRURGICALES

Abstract

The vascularized hand, provided by the superficial and deep palmar arches, shows significant anatomical variability that can influence flap planning in reconstructive surgery. CT angiography has emerged as a reliable tool for preoperative vascular assessment. This retrospective descriptive study, conducted between 2015 and 2024, included 94 adult patients treated for hand reconstruction at Annaba University Hospital. Each patient underwent a preoperative CT angiography. Vascular anatomical data, types of arterial dominance, and surgical outcomes of the flaps used were analyzed. A complete superficial palmar arch was found in 87% of cases and a complete deep arch in 75%. Ulnar dominance (type U10.R0 or U7.R3) represented 91% of vascular profiles. CT angiography allowed for comprehensive evaluation in 97% of cases, with intraoperative concordance in 92%. The flaps used (Cross-finger, Moeberg and O’Brien, and Faucher’s “kite” flap) were selected according to the angiographic findings, providing satisfactory functional coverage in all cases. CT angiography represents a highly valuable preoperative tool for vascular mapping of the hand. It enables individualised surgical planning, enhances flap safety, and optimises outcomes in post-traumatic reconstructive surgery.