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目的 探讨第一掌骨颈桡侧穿支皮瓣的解剖基础及游离移植修复手指软组织缺损的临床疗效.方法 对10例上肢(前臂及手部)标本行乳胶灌注后,观测第一掌骨颈桡侧穿支管径、交通支及分布范围,并于2014年3月至2014年12月采用以第一掌骨颈桡侧穿支为蒂的鱼际区皮瓣游离移植修复手指创面20例.结果 解剖研究的10例标本均存在第一掌骨颈桡侧穿支,并且皮瓣静脉回流丰富,有第一掌骨颈桡侧穿支伴行静脉及真皮下浅静脉两套系统,皮瓣感觉主要由前臂外侧皮神经及桡神经浅支的分支支配.临床上20例皮瓣均存活,随访时间3～9个月,平均6个月.创面愈合良好,皮瓣质地柔软、耐磨,外形、感觉、功能好.结论 第一掌骨颈桡侧穿支管径、交通支及分布范围较为恒定,符合穿支皮瓣“受区修复重建好,供区破坏损失小”的原则,是修复手指创面的选择之一.“,”Objective To investigate the anatomy of the first metacarpal neck radial perforator flap and evaluate the clinical results of free transplantation of the flap to repair soft tissue defects of the fingers.Methods Ten upper extremity (forearm and hand) cadaver specimens were perfused with red latex for dissection and observation of the vasculature around the first metacarpal neck.The diameter, communicating branches and perfusion area of the radial perforator were measured and recorded.Clinically a thenar flap based on the radial perforator around the first metacarpal neck was transferred to repair soft tissue defect of the hand in 20 cases from March 2014 to December 2014.Results The radial perforator was constant around the first metacarpal neck in the anatomic study of the 10 specimens.The perforator flap had robust venous drainage which included two venous systems, the venae comitantes of the radial perforator and the superficial dermal veins.The flap was innervated by the lateral antebrachial cutaneous nerve and branches of the superficial radial nerve.Clinically all 20 flaps survived.Postoperative follow-up ranged from 3 to 9 months, with an average of 6 months.The wound healed well.The flap was soft and durable.The appearance and sensation of the flap were good, so was hand function.Conclusion The diameter, communicating branches and peffusion range of the first metacarpal neck radial perforator are relatively constant.The radial perforator flap fulfills the motto “maximum restoration of the recipient site with minimum loss and damage to the donor site”.This flap is one of the choices to repair soft tissue defects of the finger.