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An anatomical study made in 25 injected fresh subjects made it possible to map out the periosteal flaps capable of being raised on the limbs. The preferred donor sites are the distal third of the humerus, the iliac fossa and the distal third of the femur. At the last 2 sites composite osteo-periosteal or musculo-osteo-periosteal flaps can be raised. These technical possibilities illustrate the importance of experimental studies which have shown the osteogenic capacity of grafts of vascularized periosteum.

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The length, caliber and course of the perforating branch of the peroneal artery are described following examination of both feet of 20 cadavers. This terminal branch of the peroneal artery has a constant, predictable course and may normally be sacrificed without any vascular compromise in the foot. It has great surgical potential at it is strategically situated so that it can act as a vascular pedicle for a large cutaneous flap situated on the lower lateral leg, with an axis of rotation centered at the midtarsal joint. This has been used by the senior author (AC Masquelet) as a pedicle flap and as an island flap for reconstruction of the foot and ankle with satisfying results.

No abstract