ABSTRACT
Based on the dissection of 20 fresh cadaver legs, the authors have further defined
the vascular anatomy of the peroneal artery and its cutaneous perforator vessels.
They identified a total of 95 cutaneous perforators of the peroneal artery greater
then 0.3 mm in 20 legs. The average number of cutaneous perforators was 4.8 (range:
three to seven) per leg. The cutaneous perforators were either musculocutaneous (34
percent) or septocutaneous (66 percent). The musculocutaneous perforators were found
predominantly in the upper two-thirds of the lower leg; the septocutaneous perforators
were located in the lower two-thirds of the leg. The external diameter of the cutaneous
perforators at the posterior border of the fibula was 0.6 (range: 0.3 to 1.5) mm.
The blood supply of the proximal fibula epiphysis and fibula head was found not to
be in the vascular territory of the peroneal artery. These results are the basis of
the established osteoseptocutaneous fibula transfer, the peroneal fasciocutaneous
free flap, and the double-paddle peroneal tissue transfer that all require dissection
of highly vascularized tissue adjacent to the fibula, in order to reach the peroneal
vessels. These constant anatomic findings should encourage the surgeon to harvest
skin flaps just to the level of the posterior border of the fibula, thereby creating
perforator flaps based on the peroneal system.
KEYWORDS
Peroneal artery vasculature - perforator vessels - perforator flaps
