A, Vascularized free fibular transfer. Skin incision. B, Cross-sectional view of leg with planned course of dissection around fibula. C, Interval between soleus and peroneal muscles defined and developed. D, Peroneal vessels identified just distal and deep to fibular origin of soleus muscle in proximal part of dissection. Soleus origin released with scissor dissection. E, Anterior fibular dissection, releasing peroneal muscles in extraperiosteal fashion, protecting peroneal nerve proximally. F, Anterior dissection continues through anterior intermuscular septum, releasing anterior muscles off fibula and protecting deep peroneal nerve and anterior tibial vessels. G, Distal and proximal osteotomies have been completed using Gigli saw. Peroneal vessels are seen ligated distally. Fibula is externally rotated for incision of intermuscular septum close to fibula. H, Posterior tibial muscle is released from fibula. I, Completed dissection after release of flexor hallucis longus, leaving thin layer of muscle to protect peroneal vessels. SEE TECHNIQUE 63.20.