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目的:运用混合现实技术定位股前外侧皮瓣穿支，探讨实时定位在游离皮瓣修复手部创面中的应用价值。方法:自2019年2月至2019年7月，我们采用游离股前外侧皮瓣修复手部创面患者12例。术前建立3D骨-血管-皮肤模型，模拟吻合血管，观察吻合口匹配情况。设计皮瓣应用混合现实技术将3D模型投照于术区，实时观察虚拟血管走行，依其方向探查穿支，观察虚拟图像和实际解剖所得穿支定位符合情况。采用皮瓣晚期评定标准进行疗效评价。结果:术后12例游离皮瓣均存活，随访时间为3～6个月，平均4.2个月。按皮瓣晚期评定标准评价疗效：优3例，良7例，可2例。术中应用混合现实技术定位，虚拟穿支走行与实体解剖完全一致，图像重合率为100%。结论:混合现实技术用于游离股前外侧皮瓣的切取可以获得实时而精准的穿支定位。“,”Objective:To locate the perforator of anterolateral thigh flap with the mixed reality technique and study the application value of real-time location in free flap in the repair of hand wound.Methods:From February 2019 to July 2019, 12 cases of hand wounds were treated with free anterolateral thigh flap. Before operation, 3D bone-vessel-skin model was established to simulate the anastomotic vessels and observe the anastomotic match. The 3D model of the flap was projected on the operation area by the mixed reality technique in flap design. The virtual blood vessel was observed in real time, and the perforating branches were explored according to its direction. The accordance situation of the perforator location obtained from the virtual image and the actual anatomy was observed. The clinical efficacy was evaluated according to the criteria of flap at late stage.Results:All the 12 cases of free flaps survived uneventfully after operation. The follow-up time ranged from 3 to 6 months with an average of 4.2 months. According to the criteria of flap at late stage, the results were rated as excellent in 3 cases, good in 7 cases and fair in 2 cases. During the operation, the virtual perforator was located by the mixed reality technique, and the virtual perforator was exactly the same as the solid anatomy with the image coincidence rate being 100%.Conclusion:The mixed reality technique can be used to obtain real-time and accurate perforator location for free anterolateral femoral flap.