目的:探讨尺动脉腕上皮支降支皮瓣血管解剖学基础,总结临床应用经验。方法:5侧成人新鲜上肢标本经动脉红色乳胶灌注并解剖,观察尺动脉腕上皮支降支的起始处外径,走形距离,分支及吻合支情况。1侧成人新鲜上肢标本经氧化铅灌注,分别于灌注后2、4h行x线片摄影,观察尺动脉腕上皮支降支走形情况。临床上设计切取以尺动脉腕上皮支降支为蒂的游离皮瓣修复手部皮肤软组织缺损共计87例91块皮瓣。结果:尺动脉腕上皮支降支发出部位比较恒定,沿途分支较多,其中包括皮肤支、肌支、骨膜支,起始处外径(1.0±0.3)mm。主要营养前臂远端尺侧皮肤、腕部尺侧皮肤、手背尺侧皮肤血供。临床设计游离皮瓣87例91块修复手部软组织缺损,除1例皮瓣远端部分坏死,经二次手术植皮后愈合,其余皮瓣全部成活。术后随访6个月～3年(平均12个月),皮瓣血运、质地、弹性良好,外形美观,对供区损伤小。结论:以尺动脉腕上皮支降支为蒂的游离皮瓣修复手部创面是一种理想的方法,临床上可依具体情况选择不同的方法来修复。 Objective: To explore the basis of vascular anatomy of ulnar branch of the ulnar artery and to summarize the clinical experience. Methods: The fresh upper limbs of 5 adults were perfused and dissected with red latex. The diameter, distance, branch and anastomosis were observed at the beginning of the descending branch of the ulnar artery of the ulnar artery. One side of adult fresh upper limbs were perfused with lead oxide and radiographs were taken at 2,4 hours after perfusion to observe the shape of branch and branch of the wrist artery. Clinic design to cut off the free articular flap pedicled with free skin flap to repair hand skin soft tissue defects in a total of 87 cases 91 flap. Results: The branch of the branch of ulnar artery of the ulnar artery was relatively constant and had many branches along the way, including the skin branch, muscular branch and periosteal branch. The outer diameter at the beginning was (1.0 ± 0.3) mm. The main nutrition forearm distal ulnar skin, wrist ulnar skin, hand back ulnar skin blood supply. Clinical design of free flap 87 cases of 91 repair soft tissue defects in the hand, except for 1 case of distal necrosis of the flap, after the second skin graft healing, the remaining flaps all survived. The patients were followed up for 6 months to 3 years (average 12 months). The blood flow, texture and elasticity of the flap were good and the appearance was beautiful. CONCLUSION: Free skin flap pedicled with branch of wrist of the ulnar artery is an ideal method for repairing hand wound. Clinically, different methods may be used to repair the wound.