The fibular nutrient foramen is the opening in the posterior fibular cortex in the proximal third of the fibular shaft, through which the fibular nutrient artery enters the medullary canal. Its position approximately 10-15 cm from the fibular head is a key landmark in fibular free flap harvest.
The fibular nutrient foramen position determines the safe osteotomy levels for fibular free flap harvest — the flap segment must include the foramen to preserve endosteal vascularity. It appears as a small canal in the posterior fibular cortex on CT, important for surgical planning. In fibular shaft fractures at this level, nutrient artery disruption increases fracture healing time. The foramen's position corresponds to where the peroneal vessels are closest to the fibular cortex.
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