目的:探讨游离腓肠内侧动脉穿支皮瓣修复手背软组织缺损的临床效果。方法:采用回顾性病例系列研究分析2018年5月至2020年3月遵义医科大学附属医院收治的12例手背软组织缺损患者临床资料，其中男7例，女5例；年龄24～56岁[(38±9)岁]。创面位于掌背侧9例，面积3 cm×4 cm～4.5 cm×13 cm。创面位于指背侧3例，累及单个手指1例，累及2个手指2例。于小腿内后侧设计腓肠内侧动脉穿支皮瓣，其中皮瓣采用单穿支5例，2个穿支5例，3个穿支2例。皮瓣切取后修复手背创面，其中采用分叶皮瓣2例，皮瓣供区直接缝合。观察皮瓣是否成活、外观、质地、Weber两点辨别觉试验。采用中华医学会手外科学会上肢功能评定试用标准评定掌指和指间关节伸屈功能。观察小腿供区并发症情况。结果:患者均获随访6～20个月[(10±1)个月]。皮瓣全部成活，皮瓣外形、质地良好，皮瓣形成保护性感觉，两点辨别距离5.0～6.5 cm。掌指及指间关节伸屈功能评分：掌指关节4.1～5.0分，近指关节3.1～4.0分，远指关节2.1～3分。皮瓣供区仅残留线装瘢痕，对小腿功能无影响。结论:腓肠内侧动脉穿支恒定，对供区损伤小，术后皮瓣成活率高、手功能恢复满意，是修复手背软组织缺损的较好选择。“,”Objective:To explore the clinical effect of free medial sural artery perforator flap in treatment of dorsal soft tissue defects of the hand.Methods:A retrospective case series study was used to analyze clinical data of 12 patients with soft tissue defects in the dorsum of the hand admitted to Affiliated Hospital of Zunyi Medical University from May 2018 to March 2020. There were 7 males and 5 females, with the age of 24-56 years [(38±9)years]. The wound was located on the back of the palm in 9 patients, with an area of 3 cm×4 cm-4.5 cm×13 cm. The wound was located on the back of the finger in 3 patients, with one finger involved in 1 patient and two fingers involved in 2 patients. The medial sural artery perforator flap was designed on the medial and posterior side of the leg. The flap included single perforator in 5 patients, 2 perforators in 5 patients, and 3 perforators in 2 patients. After the skin flap was harvested, the wound on the dorsum of the hand was repaired. Among them, 2 patients were repaired using the leaflet skin flap. The skin flap donor area was sutured directly. The flap's survival, texture and appearance was observed. The Weber two-point discrimination was measured. The extension and flexion scores of the metacarpophalangeal and interphalangeal joints were evaluated by the evaluation standard of upper limb function by society of hand surgery of Chinese Medical Association. The complications of the donor site was detected.Results:All patients were followed up for 6-20 months [(10±1)months]. All flaps survived with good appearance and texture. The distance between the two points was 5.0-6.5 cm. Regarding the score of extension and flexion function of the metacarpophalangeal and interphalangeal joints, the metacarpophalangeal joint was 4.1-5.0 points, the proximal finger joints was 3.1-4.0 points, and the distal finger joints was 2.1-3 points. A linear scar remained at the donor area, but had no effect on leg function.Conclusion:The medial sural artery has the advantages of constant perforation, little damage to the donor site, high flap survival rate after surgery and satisfactory recovery of hand function, suggesting a good choice for treatment of soft tissue defects on the dorsum of the hand.