TOPOGRAPHICAL ANATOMY OF THE FIBULA AND PERONEAL ARTERY IN KOREANS

Choi, Sung Weon; Cha, In Ho; Kim, Hee Jin; Koh, Ki Seok; Chung, In Hyuk

Abstract

The vascularized fibula flap, first described in 1975, was originally developed as a vascularized bone flap for extremity reconstruction. In 1989, the first experience with fibula free flap for mandibular reconstruction was published by Hidalgo. Vascularized fibula flaps have many advantages in the restoration of the contour and function of mandible. But a potential disvantages is unreliable skin paddle and the limited volume of fibula. So, we were dissected 63 Korean cadaver limbs. The aim of this study was 1) to define more clearly the anatomy of peroneal artery to fibula and lateral leg skin, specially with regard to the fibular osteocutaneous flap 2) to measure the dimensions of fibula available for dental implant placement. The results were as follows: 1. The peroneal artery arised from the posterior tibial artery in 60 cases(95.2%). But in 3 cases(4.8%), it took place of the posterior tibial artery. The peroneal artery branched off the posterior tibial artery 6.3+/-1.3cm(range 2 - 6.5cm) distal to the fibular head. 2. The musculoperiosteal and septocutaneous branches of the peroneal artery were distributed from 4/10 to 8/10 in most cases. 3. The number of nutrient foramen was one in 60 cases(95.2%). The foramen was positioned on the posterior surface in 50 cases(75.8%) The average foraminal index was 42.4+/-0.8% and its range was 30.2 to 73.3%. 4. The total length of fibula was 35.4+/-1.8 cm (range 31.0 - 39.5cm) in males and 31.3+/-1.5cm(range 28.0 - 35.0cm) in females. 5. The bone height from the base(anatomic posterior surface) to the spot at which was reduced to 6.0mm in midpoint of fibula was 12.3+/-1.8mm in males and 8.8+/-1.9mm in females.