title: [Angiosome of the fibular artery as anatomic basis for free composite fibular flap].
abstract: BACKGROUND
  The free osteoseptocutaneus fibular flap is, anatomically, an angiosome of the fibular artery. Knowledge of detailed topography anatomy of the fibular artery and its branches is necessary for successful creation and elevation of the flap.
  
  
  OBJECTIVE
  The aim of the study was to determine topography of the tissue of the leg supplied only by the fibular artery, to describe topography relations of the branches of the fibular artery, their number, anastomoses, vascular plexus and the way of vascularization of the skin, muscle and bone tissue.
  
  
  METHODS
  The popliteal artery was cannulated in 15 cadaveric legs, flushed with ink and then with 10% ink-gelatin. Fixation of tissue was performed with formalin and then micropreparation of the side branches of the fibular artery was performed. Also, two corrosive models were made. Localization of foramen nutrition was determined by measuring 50 fibulas.
  
  
  RESULTS
  The skin supplied by the fibular artery forms distal two thirds of the lateral-posterior aspect of the leg. Vascularization of the skin arises from the side branches of the fibular artery forming a rich fascia plexus at the deep fascia level. From 3 up to 7 side branches of the fibular artery are incorporated in the fascia arterial plexus and can be separated as septocutaneus and myocutaneus, according to topography relations. The nutritive artery enters the fibula cortex at a spot that, measured from the top of the fibula, lies in the area between 32% and 65% of the whole length of the fibula. Periosteal circulation of the fibula originates from the short side branches of the fibular artery that anastomoses at the periosteum level.
  
  
  CONCLUSIONS
  The axial line of flap has to be marked 2 cm posterior to the line from caput fibulae to malleolus lateralis. Numerous anastomoses between the side branches of the fibular artery in the fascia plexus enable good circulation of the skin even when some of the branches are not included in the flap. The middle third of fibula has to be used as bone graft because of localization of the foramen nutrition.
authors.forename: Radovan
authors.initials: R
authors.lastname: Manojlović
authors.forename: Milan
authors.initials: M
authors.lastname: Milisavljević
authors.forename: Dejan
authors.initials: D
authors.lastname: Tabaković
authors.forename: Mila
authors.initials: M
authors.lastname: Cetković
authors.forename: Marko
authors.initials: M
authors.lastname: Bumbasirević
mesh_terms: D001158:Arteries / Q000033:anatomy & histology; D006801:Humans; D007866:Leg / Q000098:blood supply*; D012867:Skin / Q000098:blood supply; D013524:Surgical Flaps / Q000098:blood supply*