Subscribe to RSS
DOI: 10.1055/s-2005-864845
Fibula Osteoseptocutaneous Flap with a Variant Perforator and Peroneal Artery Arising from the Anterior Tibial Artery
Publication History
Accepted: August 13, 2004
Publication Date:
28 February 2005 (online)
![](https://www.thieme-connect.de/media/jrm/200502/lookinside/thumbnails/10.1055-s-2005-864845-1.jpg)
ABSTRACT
Since the report of the first cases of vascularized free fibula graft for treatment of open fracture of the tibia and fibula in 1975, there have been many other reports of the use of vascularized free osteocutaneous fibula flaps for reconstruction of the mandible or lower leg. Usually, these flaps have a single pedicle composed of the peroneal artery, to supply the fibula with septocutaneous or musculocutaneous branches arising from the peroneal artery to supply the lateral skin of the leg. Although some authors have reported variant perforators, there have been no reports of the peroneal artery arising from the anterior tibial artery and perforator arising from the posterior tibial artery. This is the first report of a variant of the peroneal artery and perforator using a vascularized free osteocutaneous fibula flap.
KEYWORDS
Osteocutaneous fibula flap - peroneal artery - anterior tibial artery
REFERENCES
- 1 Taylor G I, Miller G D, Ham F J. The free vascularized bone graft: A clinical extension of microvascular technique. Plast Reconstr Surg. 1975; 55 533-544
- 2 Shaw W W, Hidalgo D A. Microsurgery in Trauma. Mount Kisco,NY; Futura Publishing Company 1987
- 3 Kessler P, Wiltfang J, Shultze-Mosgau S et al.. The role of angiography in the lower extremity using free vascularized fibular transplants for mandibular reconstruction. J Craniomaxillofac Surg. 2001; 29 332-336
- 4 Seres L, Csaszar J, Voros E, Borbely L. Donor site angiography before mandibular reconstruction with fibula free flap. J Craniofac Surg. 2001; 12 608-613
- 5 Hallock G G, Anous M M, Sheridan B C. The surgical anatomy of the principal nutrient vessel of the tibia. Plast Reconstr Surg. 1993; 92 49-54
- 6 Strauch B, Yu H L, Chen Z W, Liebling R. Atlas of Microvascular Surgery. New York, NY; Thieme Medical Publishers Inc 1993: 218-220
- 7 Wei F C, Chen H C, Chuang C C, Noordhoff M S. Fibular osteoseptocutaneous flap: anotomic study and clinical application. Plast Reconstr Surg. 1986; 78 191-199
- 8 Chen Z W, Yan W. The study and clinical application of the osteocutaneous flap of fibula. Microsurgery. 1983; 4 11-16
- 9 Chen Y L, Zheng B G, Zhu J M et al.. Microsurgical anatomy of the lateral skin flap of the leg. Ann Plast Surg. 1985; 15 313-318
- 10 Kim D, Orreon D E, Skillman J J. Surgical significance of popliteal arterial variants: a unified angiographic classification. Ann Surg. 1989; 210 776-781
- 11 Lutz B S, Wei F C, Ng S H et al.. Routine donor leg angiography before vascularized free fibula transplantation is not necessary: a prospective study in 120 clinical cases. Plast Reconstr Surg. 1999; 103 121-127
- 12 Disa J J, Corderio P G. The current role of preoperative arteriography in free fibula flaps. Plast Reconstr Surg. 1998; 102 1083-1088
- 13 Weber R A, Pederson W C. Skin paddle salvage in the fibula osteocutaneous free flap with secondary skin paddle vascular anastomosis. J Reconstr Microsurg. 1995; 11 242-244
- 14 Winters H AH, De Jongh G J. Reliability of the proximal skin paddle of the osteocutaneous free fibula flap: a prospective clinical study. Plast Reconstr Surg. 1999; 103 846-849
- 15 Yokoo S, Komori T, Furudoi S et al.. Rare variant of the intrasoleus musculocutaneous perforator: clinical considerations in raising a free peroneal osteocutanesous flap. J Reconstr Microsurg. 2001; 17 225-228
Hiroaki NakazawaM.D.
Department of Plastic and Reconstructive Surgery, Tokyo Women's Medical University
8-1, Kawada-cho, Shinjuku-ku, Tokyo, Japan