Fibular artery !

The fibular artery is a branch of the posterior tibial artery that runs along the fibula, deep in the back of the leg.

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What it is

A branch of the posterior tibial artery that runs deep along the fibula.

What it does

Supplies the muscles on the outer and back parts of the leg and the fibula.

Key facts

Origin: Posterior tibial artery, about 2–3 cm below popliteus
Branches: Muscular, nutrient artery of fibula, perforating, communicating and lateral calcaneal branches
Supplies: Lateral and deep posterior leg muscles, fibula, lateral ankle and heel

Relations

Course: Leaves the posterior tibial artery below the popliteus, runs down and laterally to the fibula and descends along its medial crest, between the tibialis posterior and flexor hallucis longus or within the latter, ending behind the lateral malleolus in calcaneal branches
Lateral: The fibula, which receives its nutrient artery
Superficial: The soleus and flexor hallucis longus
Deep: The tibialis posterior and the interosseous membrane

How to find it

Not palpable. In flap harvest it is reached from the lateral side of the leg, behind the fibula, between the lateral and posterior compartments; CT angiography shows it running alongside the fibula.

Examination

Before a fibula flap, the ankle pulses and their Doppler signals are checked; weak or absent signals raise concern that the foot depends on this artery

On imaging

With no pulse of its own it is judged on imaging: CT or catheter angiography before a fibula flap confirms that both tibial arteries reach the foot, and duplex can follow it along the back of the fibula.

Clinical notes

The fibula flap can carry a skin paddle on small perforators from this artery that run in the posterior crural septum
Because three arteries feed the leg, losing the fibular artery alone is usually tolerated, unless it is the dominant artery of the foot

Anatomical variants

Peroneal magnus: in up to about 5% it is the dominant supply of the foot, replacing a small or absent posterior or anterior tibial artery; harvesting it would then endanger the foot
May arise from the anterior tibial artery, or straight from the popliteal artery as part of a trifurcation

Development

It keeps part of the path of the embryonic axial (sciatic) artery, the limb's first main vessel, later replaced by the femoral system. Rarely the sciatic artery persists and tends to form aneurysms.

Test yourself

Think of the answer, then tap the question to see it.

Where does the fibular artery arise, and where does it run?

From the posterior tibial artery about 2–3 cm below the popliteus; it descends along the medial crest of the fibula.

Which major reconstructive flap is based on the fibular artery?

The free fibula flap, the main bone flap for rebuilding the jaw.

Which branch of the fibular artery can replace a missing dorsalis pedis artery?

The perforating branch, which pierces the interosseous membrane above the lateral malleolus.

What is a «peroneal magnus», and why does it matter?

A fibular artery that is the dominant supply of the foot; harvesting it for a flap would endanger the foot.

Which embryonic vessel survives in part as the fibular artery?

The axial (sciatic) artery, the first main artery of the lower limb.

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Educational information, not medical advice. For any symptom, see a health professional.

Its names

Official Latin (TA2): arteria fibularis TA2 4727
Official Spanish (DeCS): Arteria fibular
English (TA2): Fibular artery
Also called: peroneal artery

Sources: Terminologia Anatomica (TA2); Anatomy, Bony Pelvis and Lower Limb: Peroneal Artery; 20.5 Circulatory Pathways (OpenStax (Rice University), 2022) · adapted, CC BY 4.0; Anatomy of the Human Body (20th ed.): The Arteries of the Lower Extremity (Lea & Febiger (Gray's Anatomy, 1918), 1918) · adapted, Public domain.

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Representative model, for educational purposes only.

Fibular artery highlighted on the Durgical 3D model