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Related Experiment Videos

The osteocutaneous fibula flap: an anatomic study.

M Beppu1, D P Hanel, G H Johnston

  • 1Christine M. Kleinert Institute for Hand and Micro Surgery, Louisville, Kentucky.

Journal of Reconstructive Microsurgery
|May 1, 1992
PubMed
Summary

Dissections of the peroneal artery in cadavers clarified fibula flap anatomy. Reliable skin branches for the fibula flap are primarily in the lower leg, supplying periosteal blood flow.

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Area of Science:

  • Anatomy
  • Vascular Surgery
  • Microsurgery

Background:

  • Discrepancies exist in current literature regarding the anatomical course of cutaneous branches originating from the peroneal artery.
  • Understanding these vascular pathways is crucial for successful fibula flap harvesting in reconstructive surgery.

Purpose of the Study:

  • To precisely delineate the anatomy of the cutaneous branches of the peroneal artery.
  • To identify the most consistent locations and courses of these vessels for improved fibula flap design.

Main Methods:

  • Performed detailed dissections on 35 injected fresh cadaver legs.
  • Documented the origin, course, and distribution of all identifiable skin branches of the peroneal artery.

Main Results:

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  • Identifiable skin branches were present in 23 out of 25 (92%) dissected legs.
  • Branches from the proximal peroneal artery consistently followed an intramuscular path.
  • Branches from the distal two-thirds of the peroneal artery were typically found within the posterior crural septum.
  • An average of 4.7 branches per leg were identified, all contributing to fibular periosteal blood supply.
  • The most consistently located branch was within 2 cm of the fibula midpoint.

Conclusions:

  • The fibula flap can reliably incorporate a large skin island due to consistent peroneal artery cutaneous branches.
  • The most dependable cutaneous vessels for fibula flaps are located in the distal two-thirds of the leg.
  • These reliable vessels run within the posterior crural septum, posterior to the fibula, and are associated with muscular branches.