What is the primary blood supply to a free fibula graft?

The primary blood supply to a free fibula graft is via the peroneal artery. The peroneal artery, a branch of the posterior tibial artery, is the main vessel responsible for providing blood flow to the fibula, particularly the proximal region where the graft is harvested.

When harvesting a free fibula flap, the peroneal artery and its accompanying veins are carefully dissected to ensure a good vascular supply to the graft. This is crucial for the viability of the graft once it is transplanted to another site, as adequate blood supply is necessary to prevent necrosis and promote healing.

The other options listed are not the primary sources of blood supply for a free fibula graft: the femoral artery supplies the thigh, but its branches primarily fertilities the quadriceps and not the fibula; the popliteal artery, while it provides important blood flow to the knee and lower leg, is not the direct source of blood for the fibula itself; and the tibial artery generally supplies the anterior leg and foot structures rather than the fibula directly. The anatomical relationship and the branches involved emphasize the significance of the peroneal artery in ensuring the viability of the graft during and after the surgical procedure.