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CC BY-NC-ND 4.0 · Indian J Plast Surg 2009; 42(02): 255-257
DOI: 10.1055/s-0039-1699357
Case Report
Association of Plastic Surgeons of India

Successful management of free osteocutaneous fibula flap with anomalous vascularity of the skin paddle

Prabha S. Yadav
Plastic and Reconstructive Services, Department of Surgical Oncology, TATA Memorial Hospital, Parel, Mumbai – 400 012, India.
,
Quazi G. Ahmad
Plastic and Reconstructive Services, Department of Surgical Oncology, TATA Memorial Hospital, Parel, Mumbai – 400 012, India.
,
Vinay Kant Shankhdhar
Plastic and Reconstructive Services, Department of Surgical Oncology, TATA Memorial Hospital, Parel, Mumbai – 400 012, India.
,
G. I. Nambi
Plastic and Reconstructive Services, Department of Surgical Oncology, TATA Memorial Hospital, Parel, Mumbai – 400 012, India.
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Publikationsdatum:
15. Januar 2020 (online)

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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.

KEY WORDS

Anomalous perforator - double vascular anastomosis - osteocutaneous fibula flap
 

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