The Osteocutaneous Free Fibula Flap

Perforator flaps: the next step in the reconstructive ladder?

“…The anatomy of the lower leg perforators was thoroughly investigated in the early 90s when the reliability of the fibular skin paddle was described. 29 The peroneal vessels give off about 3-4 perforators, predominantly with a myocutaneous course in the proximal, and a septocutaneous course in the distal, half of the lower leg. According to a recent overview, the most reliable perforator is located at the transition of the middle and distal thirds.…”

Further experience with the free soleus perforator flaps using CT-angiography as a planning tool – A preliminary study

“…On the other hand, the raising of these flaps leads to a negligible donor site morbidity, and the flaps are thin and pliable, making the ideally suited for head and neck reconstruction. It is known from numerous clinical and anatomical studies (Yoshimura et al, 1990;Schusterman et al, 1992;Weber and Pederson, 1995;Yokoo et al, 2001;Heitmann et al, 2003), that neither the number, course, location, or size of the lateral lower leg perforators can be predicted reliably, so that flap raising can always be associated with unexpected intra-operative findings making primary closure or even a successful flap transfer impossible. Therefore, the ability to pre-operatively evaluate the vascular anatomy for these flaps would be beneficial.…”

Surgical Planning in Reconstruction of Mandibular Defect With Fibula Free Flap: 15 Patients

“…These reconstructions were based on accurate anatomical dissections for the definition of the circulatory system from the peroneal artery to the cutaneous tissue above. [11][12][13][14][15][16] The use of revascularized fibula free flaps provides modern maxillofacial surgery with the chance to perform reconstructions of wide mandibular defects. Fibula flaps, compared with the iliac crest, the radius, the scapula, and the ribs, ensure more advantages and better results.…”