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目的:探索应用削薄股前外侧穿支皮瓣（ALTP）修复足踝部较大面积软组织缺损的手术方式及临床应用效果。方法:回顾性分析自2017年1月至2020年1月,采用削薄ALTP修复足踝部较大面积软组织缺损30例,其中男21例,女9例,年龄27~62岁,平均42岁。受伤原因：车祸毁损伤13例,重物砸压伤7例,肿瘤切除术后及慢性溃疡创面6例,摩托车钢圈绞伤4例；软组织缺损面积为8.0 cm×18.0 cm～24.0 cm×10.0 cm,均存在不同程度的肌腱、关节及骨骼等重要结构外露或缺损。重要肌腱予重建,缺损骨质予植骨填充。切取皮瓣面积为9.0 cm×19.0 cm~25.0 cm×11.0 cm,所有ALTP均一期进行显微削薄,并携带股外侧皮神经。术后予保温、制动及抗血管痉挛等对症处理。术后定期随访,对皮瓣成活情况、感觉恢复、患肢功能恢复及患者主观感受等进行评价。结果:本组30例皮瓣全部成活,术后24 h内发生血管危象2例,经急诊手术探查后成活,1例皮瓣边缘部分坏死,经清创换药后创面愈合。30例均获得随访,随访时间6~36个月,平均18个月。所有皮瓣质地良好,外观无明显臃肿,无需再次手术削薄,皮瓣TPD 0.5～2.0 cm,评定级别为Sn 3～Sn 3+,踝关节屈伸范围为40°~60°。n 结论:削薄ALTP具有可切取面积大、外形美观、成活率高、感觉恢复较好及供区损伤小等优点,是修复足踝部较大面积软组织缺损的理想皮瓣。“,”Objective:To explore the operative method and clinical effect with thinned anterolateral thigh perforator flap (ALTP) in repair of large area soft tissue defect of foot and ankle.Methods:From January, 2017 to January, 2020, 30 cases of foot and ankle soft tissue defects were repaired with thinned ALTP, including 21 males and 9 females, aged from 27 to 62 years old, with an average of 42 years old. Causes of injury: 13 were by traffic accident, 7 were crushed by heavy weights, 6 were chronic ulcer after tumour resection and 4 were by motorcycle wheel. The areas of defect were 8.0 cm×18.0 cm-24.0 cm×10.0 cm. There were different degrees of explosion and damage to tendon, joint, bone and other important structures. The areas of flap were 9.0 cm×19.0 cm-25.0 cm×11.0 cm. All the ALTP were thinned and carried the lateral femoral cutaneous nerve. The flaps were kept warm, immobilisation and anti-vasospasm. The flaps' survival, sensory recovery, functional recovery of affected limb and subjective feeling of patients were evaluated.Results:All flaps survived. Two cases of vascular crisis occurred within 24 hours after operation, and 1 flap with edge necrosis and healed after debridement and dressing change. All 30 cases were followed-up for 6-36 months, with an average of 18 months. All flaps had good texture, no obvious bulky appearance and required no further thinning. The TPD ranged between 0.5-2.0 cm, sensory restoration was Sn 3-Sn 3+, and the range of motion of the ankle joint was 40°-60°.n Conclusion:Thinned ALTP has advantages in large donor area, beautiful appearance, high survival rate, good sensation recovery and small donor area damage. It is an ideal flap for the repair of large heel soft tissue defects.