The 'superficial' peroneal artery: a variation in cutaneous branching fromthe peroneal artery, nourishing the distal third of the leg

Two different vascular patterns were encountered in cutaneous branches from the peroneal artery to the posterolateral aspect of the distal third of th e leg in 22 flaps from 22 patients who underwent cutaneous or osteocutaneou s peroneal flap surgery. In the type 1 vascular pattern, a branch from the peroneal artery, named the 'superficial peroneal artery', nourished the pos terolateral aspect of the leg by splitting into several septocutaneous bran ches. In the type 2 pattern a few septocutaneous branches originated direct ly from the main peroneal artery and nourished the same area as that fed by the type 1 branch. The type I vascular pattern has not been reported to da te but was seen in nine out of the 22 consecutive peroneal flaps. The super ficial peroneal artery, with its considerable vascular diameter, may serve as a recipient vessel for free flaps or may serve as a donor nutrient vesse l for a cutaneous flap, which can be transferred without sacrificing the ma in peroneal artery. Awareness of these two vascular patterns in the distal third of the leg should also help to reduce the small percentage of skin-fl ap failures that occur when the cutaneous or osteocutaneous peroneal flap i s used. (C) 2001 The British Association of Plastic Surgeons.