The fibula is well recognized as a cortical graft and is reported to be a long bone flap. It is long and straight, has good bone strength, has a tricortical structure and can be used as a graft up to 22 cm in size (Fig. 4.1a, b). Its dimensions permit it to anatomically match forearm bones and can also be used as a single graft to repair forearm bone defects. It can also be fixed into the medullary canals of major long bones like the femur, tibia and humerus (Fig. 4.2). The fibula derived its direct arterial supply from the peroneal artery. The outer third of the bone has profuse periosteal circulation.