Peroneal (Fibular) Artery

arteria peronea (fibularis)

The peroneal (fibular) artery is the largest branch of the posterior tibial artery, running adjacent to the fibula and supplying both the deep posterior compartment and the lateral compartment through perforating branches. The fibula depends on the peroneal artery for its periosteal blood supply, and this consistent pedicle makes the fibula the preferred vascularised bone for free tissue transfer in jaw and long bone reconstruction.

Region: Lower Leg

Anatomical Data

Origin, Insertion & Supply

Origin	Posterior tibial artery approximately 2.5 cm below the popliteus, the largest branch of the posterior tibial

Clinical Relevance

Clinical Notes

Fibula free flap harvest for mandible reconstruction or tibial defect bridging relies on the reliable peroneal artery pedicle. Pre-operative angiography or CT angiography confirms adequate peroneal artery anatomy and ensures the foot can tolerate fibula loss without ischaemia. In peripheral vascular disease, the peroneal artery is often the last patent tibial vessel and provides essential collateral flow to the foot via its distal perforating branch.

Pathology

Common Injuries & Conditions

Tibial and Peroneal Artery Occlusion

Infrapopliteal arterial occlusion from atherosclerosis producing tissue loss and non-healing foot wounds, managed with angioplasty or bypass for revascularisation.