Clinicoanatomical Study of the Free Vascularized Osteocutaneous Fibula Flap

Vessels of the Peroneal Region and Fibula

Abstract

The clinical anatomy of the vascularized fibula flap and peroneal vessels was investigated using 41 cadavers.
The results were as follows:
1. Results of the morphologic examination: 1) Peroneal nutrient arteries were classified as three types: the facies posterior fibulae type (peroneal nutrient arteries that run from posterior to anterior and enter the facies posterior fibulae) accounted for 83%. 2) Type II (two peronealveins and two posterior tibial veins joined to form two posterior tibial veins) accounted for 98. 1%. 3) Most valves (96.9 %) were bicuspid. 4) Venous valves were found most often at confluences.
2. Results of morphometric examination: 1) The level of origin of the peroneal artery was 6.8 cm distal to the apex capitis fibulae. 2) The maximal length of peroneal vessels that could be used as bone flap pedicles were 7.8cm for arteries and 7. lcm for veins. 3) The totallength of the fibula was 32. 6cm, and the maximal length that could be used for bone grafts was 21.7 cm. 4) The maximal width of the fibular cross sections was 13.1 mm. 5) The maximal cortical thickness of the fibular cross sections was 4.1 mm.