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Anatomical basis for the use of the fibularis tertius muscle in myocutaneous flaps

BACKGROUND: Myocutaneous flaps have been increasingly used in surgical reconstruction of the lower limbs, requiring the use of muscles that result in less functional and esthetic damage as flaps. This study aimed to evaluate the use of the fibularis tertius muscle (in terms of frequency and anatomy) as flaps in this procedure. METHODS: Sixty-four lower limbs from preserved cadavers were dissected and evaluated based on the following parameters: proximal insertion, distal insertion, syntopy, morphology, and morphometry. RESULTS: The fibularis tertius muscle was detected in 96.9% of the study cases. Most proximal insertions (96.8%) were found at the interosseous membrane, anterior border of the fibula, and anterior intermuscular septum. Most distal insertions (77.4%) were found at the lateral and dorsal sides of the 5th metatarsal. Mean value of muscle belly length was 17.89 cm and width was 1.95 cm. The mean length of the distal tendon with no muscle fibers was 1.2 cm, and the mean width was 0.45 cm. CONCLUSIONS: The fibularis tertius muscle is frequent and has a distinct morphology, making it a viable option for the repair of lower limb (distal segment) defects.

Surgical flaps; Plastic surgery; Lower extremity


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