The authors report a case of an Y anastomosis of a free flap on the peroneal artery. A 30-year-old patient, the victim of a multi-traumatism after a motorcycle accident, presented open tibia and peroneal fractures and skin defect at the dorsal aspect of the foot uncovering several fractures and luxations of the foot. When general state of health allowed the achievement of a free flap, the authors noted that the two tibial arteries were destroyed with an extensive thrombosis on each side of the injury which precluded the reconstruction of a reliable artery axis. The peroneal artery insured alone a good foot vascularization. A musculocutaneous serratus anterior free flap was revascularized on the peroneal artery after segmental bone resection on each side of the peroneal fracture. The necessity to preserve the peroneal artery for the foot and the diameter of the arteries imposed flowthrough fashion anastomosis. As a result, the authors believe that anastomosis of a free flap on peroneal artery is a safe procedure, particularly interesting when a preoperative peroneal fracture achieved the osteotomy.
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