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

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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.