The review is devoted to the features of anatomy and circulation in the vessels supplying the periosteum, cortical and cancellous bone, as well as bone marrow in vascularized bone autografts. The authors analyzed the peculiarities of blood supply to long tubular bones, the features of microvasculature in the flaps comprising cancellous and tubular bones. Moreover, the mechanisms of blood flow regulation in vascularized autografts were described. A direct anatomical communication between the endosteal and periosteal circulation was established. Up to 80% of arterial and 59% of venous blood flow are ensured through these networks in the long bones of the lower leg. Microcirculation of bone marrow, cancellous and cortical bones, as well as periosteum is a single vascular system. In this regard, bone marrow degeneration throughout more than 2—3 hours of primary ischemia may be one of the most significant causes of complications in vascularized autografts comprising bone fragment.

Keywords. vascularized autografts, fibula, microcirculation, blood flow regulation