FFF Utilizing an Arteriovenous Vascular Loop of Two Peroneal Venae Comitantes for a PAM

Hailey P. Huddleston, Joey S. Kurtzman, Steven M. Koehler

Research output: Contribution to journalArticlepeer-review


Summary: Vascularized bone grafting is widely used for reconstruction of osseous defects of the forearm. Fibular free flap (FFF) is one option, which relies on harvesting the peroneal artery. This procedure is subject to lower extremity anatomic variants; therefore, some recommend preoperative angiography. However, high quality evidence for this approach and its cost-effectiveness are lacking and instead one can diligently assess the vascular anatomy intraoperatively. Here, we describe a case of a 73-year-old man who was found to have a peronea arteria magna intraoperatively during an FFF for a left radius reconstruction secondary to an infectious nonunion. We describe an approach to performing an FFF using an arteriovenous vascular loop through the fibula employing the two accompanying peroneal venae comitantes. The patient had no complications and was found to have appropriate healing of the upper extremity without lower extremity compromise at 3-month follow-up. This report illustrates an alternative to using an interpositional venous graft for peronea arteria magna found intraoperatively during FFFs.

Original languageEnglish (US)
Pages (from-to)E3790
JournalPlastic and Reconstructive Surgery - Global Open
Issue number9
StatePublished - Sep 13 2021
Externally publishedYes

ASJC Scopus subject areas

  • Surgery


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