Fibular epiphyseal transfer: the peroneal vessels revisited

The case of a seven-year-old boy with a Ewing’s sarcoma of the humerus diaphysis extending into the epiphysis proximally. He underwent chemotherapy followed by 12 cm resection of the proximal humerus with preservation of rotator cuff. Reconstruction was performed using a 15 cm vascularized fibula epiphyseal transfer raised using a postero-lateral approach based on the peroneal artery and its venae commitans. The common peroneal nerve was protected proximally and all motor branches were preserved. The pedicle length was 7cm. When isolated on the peroneal artery, bleeding was seen at the level of the epiphysis and periosteum of the fibula head.