Chimeric Free Fibula Flap: An Encounter with Aberrant Anatomy

A 59-year-old male presented with recurrent mucoepidermoid carcinoma of the mandible. A resection with immediate free fibula flap reconstruction was done. The osteocutaneous free fibula flap relies on the peroneal artery and its distal perforators. While most most commonly supplied by septocutaneous perforators, variant patterns necessitate consideration of the challenging to dissect proximal myocutaneous perforator raised on a single or double anastamosis, depending on origin. Even in cases of flap salvage the fibula flap remains a reliable flap. This case describes a fibula flap with a sole proximal myocutaneous perforator identified on dissection despite a normal preoperative doppler. No grants or funding support. No conflicts of interest to report.