Objective: To analyze the value of preoperative routine donor leg angiography in free fibula flaps.
Methods: Eighty-nine consecutive potential candidates for free fibula reconstruction were reviewed. They were further divided into two groups, group one received preoperative routine donor leg angiography, group two received only preoperative evaluation of dorsalis pedis and tibial posterior artery and without angiography.
Results: There were 49 patients in group one and 40 patients in group two. In group one, the results of preoperative angiography resulted in a change of the surgical plan in two patients. In group two, all the patients showed normal dorsilis pedis and tibial posterior artery, and fibula flap was harvested without preoperative angiography. One patient in each group showed venous deformity during the operation, and flap harvesting was abandoned.
Conclusions: Routine preoperative angiography in free fibula flap is unnecessary. The following three conditions that require an angiography are: abnormal pedal pulses, significant previous lower leg trauma, and suspected vascular diseases.