Epiphyseal transplant: harvesting technique of the proximal fibula based on the Anterior Tibial Artery.

Epiphyseal transplants in children were introduced into clinical practice about 20 years ago. Among possible donor sites, the proximal fibula is definitely the most popular choice, and has been used mainly for reconstruction of the proximal humerus and distal radius. Provided that an adequate blood supply both to the physis and to the diaphysis must be restored in order to obtain acceptable axial growth of the transferred fibula and a bone fusion at the osteotomy site, the choice of feeding pedicle is still a controversial issue. Our contribution involves a homogeneous series of 24 patients under 11 years of age who had skeletal reconstruction in the upper limb by means of a vascularized transfer of the proximal fibula based on the anterior tibial artery. The aim of the present paper is to describe in detail the harvesting technique which has been partially modified and gradually refined in our 10-year experience.