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目的:探讨应用吻合血管的腓骨(皮)瓣移植修复上肢软组织及大段骨骼、肌腱等复合组织缺损的临床治疗效果。方法:自2015年4月至2019年6月,共收治上肢大段骨缺损患者7例,男5例,女2例;年龄14~52岁,平均31.5岁;均伴有不同程度的皮肤、血管、神经、肌腱等组织缺损。根据软组织缺损种类、部位和大小(长短)情况做好术前设计,修复骨、软组织缺损的同时,自小腿供区取材修复血管、神经、肌腱组织缺损。术后定期随访。结果:7例患者腓骨(皮)瓣均成活良好,经平均15(8~36)个月随访,患者肢体功能均有不同程度恢复,供区无任何并发症发生,治疗效果满意。按Enneking系统进行评分,平均为25.9分:优4例,良3例。结论:吻合血管的腓骨(皮)瓣游离移植特别适合上肢的大段骨(皮)缺损修复,并且可一个供区同时解决皮肤、血管、神经、肌腱等组织缺损问题,修复效果好。“,”Objective:To evaluate the clinical effect of fibula flap in the repair of large segment of composite tissue defect in upper limb.Methods:From April, 2015 to June, 2019, 7 patients with large composite tissue defects in upper limbs were treated. All of them with various skin, vessel, nerve, tendon and other tissue defects. Repairing was well planned before surgery according to the type, location and size of defect. While in repairing of the bone and skin defect, fibula flap was taken from the shank and to repair the defects of nerve, tendon and vessels in upper limb. Regular followed-ups were made after surgery.Results:The 7 fibula flaps all survived. Postoperative follow-up ranged between 8 to 36 (averaged of 15) months. All the reconstructed limbs were in satisfactory appearance and function recovery. All the patients were able to manage their daily activities and live independently. The shape and function of donor sites were good. According to the Enneking system, the outcomes were graded as excellent in 4 cases and good in 3, with the average score was 25.9 points.Conclusion:Free grafting of vascularised fibula flap is especially feasible to be used in the repair of large bone tissue defect of upper limb. It repairs the defects of skin, vessel, nerve and tendon with the flap from a single donor site.