Vascular anatomy of the proximal fibula from embalmed cadaveric dissection

To study the vascular pattern of proximal fibula with use of embalmed cadaveric specimens.

The present study was done on 33 lower extremities from 19 embalmed human, adult cadavers. The average ages of the cadavers were 68.6 years (range from 36 to 98 years), 11 females and 8 males. The size and site of vessels around the proximal fibula were recorded.

There were three main blood supplies of proximal fibular the epiphyseal artery, the lateral genicular artery, and the periosteal blood supply. They are anterior tibial recurrent artery and posterior tibial artery or artery of the neck of fibula posteriorly. Inferior lateral genicular artery was seen in all specimens (33/33). Among them, 42.4% (14/33) had a single artery with double accompanied veins. The average diameter of artery and veins were 1.71 mm (0.75-2.25), and 1.69 mm (1.30-2.10), respectively. The others were single artery and single vein. The average diameter ofartery and veins were 1.66 mm (0.65-2.14), and 2. 1 mm (0. 95-2.30) respectively. Anterior tibial recurrent artery was seen in 31 of 33 specimens (94%). The average size of artery and accompanying vein were 1.24 mm (0.8-2.1), and 1.86 mm (0.8-2.6), respectively. Posterior tibial recurrent artery was an inconsistent branch that appeared in only 11 of 33 specimens (33%). Artery of the neck of fibula appeared in 24 of 33 specimens (72.7%). The others were replaced by the predominant posterior tibial recurrent artery (7/33) and neither of them was found in two specimens.

Based on the present results, the authors recommend preserving the epiphyseal blood supply, the inferior lateral genicular artery, and the periosteal blood supply for free epiphyseal transfer In addition, surgeons should pay attention to the variation of posterior periosteal blood supply because its variations will affect the viability percentage of proximal fibular epiphyseal transfer.