Observations of the blood supply to the fibula

In the surgery of upper and lower extremities autotransplantation of the fibula is often used to bridge extensive bone defects. However, insufficient blood supply affects the long-term results. Microsurgery yields better results. We investigated the blood supply of the fibula to guarantee a careful operation method and the selection of suitable grafts. In 295 fibulae the foramina nutritiva and the periosteal vessels were investigated light microscopically. Moreover, by means of five amputation preparations the course of A. poplitea and its ramifications and of all nutritive vessels was shown roentgenologically and anatomically by popliteal angiography and stain injection, respectively. The foramina nutritiva were located as follows: 66.4% in the upper third, 15% in the middle, and 13.5% in the lower third of the fibula. Double foramina were noticed 10 times, no foramina 5 times. Consequences for the operative procedure are discussed.