Nervus Communicans Fibularis Pedicled Graft: Anatomic Description and Clinical Application

End-to-end nerve repair using autografts is a standard technique in microsurgery. The environment around the nerve graft site is important. Scar tissue should be avoided as much as possible to provide a good blood supply to the graft site from healthy tissue, but this is not always possible. In some specific cases, it is useful to employ vascularized nerve grafts. The technique is not easy and frequently is more aggressive than the standard free sural nerve graft. The authors presented an anatomical description of the nervus communicans fibularis around the posterolateral aspect of the knee and its microvascularization. In addition, they described the surgical technique for using this nerve as a pedicled flap in order to improve the vascularization and regeneration of the nerve. Finally, their clinical experience with this technique in fibular nerve lesions around the knee was reported.