Anatomic study of the nutrient foramen in the shaft of the fibula.

The location of the nutrient foramen is important if a free vascularized fibular graft is to include endosteal as well as periosteal blood supply. More than 300 human fibulae were examined to determine the number, location, and size of the foramina in the shaft. Six percent of the bones had no apparent foramen. Ninety-six percent of the foramina were in the middle third of the fibula. In Caucasians this segment of the shaft should be used for free vascularized fibular transfers to increase the likelihood of including the endosteal blood supply.