Topographical anatomy of the fibula and peroneal artery in Koreans

Vascularized fibula flaps have many advantages in the restoration of the contour and function of the mandible. Potential disadvantages include, unreliable skin paddle and the limited volume of the fibula. This study was designed, to clarify the anatomy of the peroneal artery to the fibula and lateral leg skin, and to measure the dimensions of the fibula available for dental implant placement in Korean. Through the dissection of 63 legs of Korean cadavers, we demonstrated that in most cases the musculoperiosteal (mp) and septocutaneous (sc) branches of the peroneal artery were distributed at the middle and lower thirds of the fibula. There were double the number of mp perforators to the skin compared to sc branches. This indicates the inclusion of a generous >1 cm cuff of Peroneous longus and flexor hallucis longus (FHL) in the distal and middle third of the fibula. The location of the nutrient foramen was just proximal to the midpoint. Thus, a 15-20 cm length of the fibula is available in Koreans and an 8-12 min length of implant can be placed to the fibula, which provides sufficient bone to reconstruct a large mandibular defect.