title: Successful management of free osteocutaneous fibula flap with anomalous vascularity of the skin paddle.
abstract: The free osteocutaneous fibula flap is an established method of reconstruction of maxillary and mandibular defects. The vascularity of the skeletal and the cutaneous components is provided by the peroneal artery via the nutrient artery and the septo- and musculocutaneous perforators. In rare situations, these perforators may arise from other major leg arteries. In such circumstances, the procedure has to be either abandoned or modified so that neither the vascularity of the flap nor the donor limb is compromised. We present a case of an anomalous musculocutaneous perforator, which originated from the proximal part of the posterior tibial artery, passed through the soleus muscle and supplied the skin paddle. The flap was elevated as a single composite unit and was managed by two separate vascular anastomosis at the recipient site, one for the peroneal vessels and the other for the anomalous perforator.
authors.affiliation: Plastic and Reconstructive Services, Department of Surgical Oncology, TATA Memorial Hospital, Parel, Mumbai - 400 012, India.
authors.forename: Prabha S
authors.initials: PS
authors.lastname: Yadav
authors.forename: Quazi G
authors.initials: QG
authors.lastname: Ahmad
authors.forename: Vinay Kant
authors.initials: VK
authors.lastname: Shankhdhar
authors.forename: G I
authors.initials: GI
authors.lastname: Nambi