The calcaneal branch of the fibular (peroneal) artery descends posterior to the lateral malleolus to supply the lateral and posterior heel, anastomosing with medial calcaneal branches of the posterior tibial artery. It forms part of the calcaneal arterial network that sustains the heel pad.
The lateral calcaneal artery is at risk during fibular flap harvest and lateral ankle surgeries. Its disruption contributes to heel pad ischaemia in patients with peripheral vascular disease requiring lateral calcaneal procedures. Duplex ultrasound maps calcaneal arterial supply before sural flap elevation for heel reconstruction.
Compromise of lateral calcaneal perfusion after fibular artery injury or lateral heel surgery producing skin necrosis and potential wound breakdown in vascularly compromised patients.
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