A forceful impact, such as landing after a high jump or any impact to the outer aspect of the leg, can cause a fracture.
Even rolling or twisting an ankle puts pressure on the fibula bone, which can lead to a fracture.
The fibula and tibia are the two long bones in the lower leg. The fibula or calf bone is a small bone located on the outside of the leg.
The tibia is the weight-bearing bone on the inside of the lower leg. The fibula and tibia meet at the knee and ankle joints.
The two bones help stabilize and support the ankle and lower leg muscles . A fibula fracture is used to describe a break in the fibula bone.
Types and causes of fibula fractures
Fibula fractures can occur at any point in the bone and can vary in severity and type. Types of fibula fracture include the following:
- Lateral malleolus fractures occur when the fibula breaks at the ankle.
- Fibular head fractures occur at the upper end of the fibula at the knee.
- Avulsion fractures occur when a small piece of bone that is attached to a tendon or ligament separates from the main part of the bone.
- Stress fractures describe a situation where the fibula is injured as a result of repetitive stress, such as running or walking.
- Fibular shaft fractures occur in the middle of the fibula after injury, such as a direct blow to the area.
A fibula fracture can be due to many injuries, commonly a sprained ankle , but it can also be due to an awkward landing, a fall, or a direct blow to the lower leg or ankle.
Fibula fractures are common in sports, especially those that involve running, jumping, or rapid changes of direction, such as soccer, basketball, and football.
Pain, swelling, and tenderness are some of the most common signs and symptoms of a fractured fibula. Other signs and symptoms include:
- Inability to bear weight on the injured leg .
- Bleeding and bruising on the leg.
- Visible deformity.
- Numbness and coldness in the foot.
- Pain to touch
Diagnosis of fibula fractures
People who have injured their leg and are experiencing any of the symptoms should see a doctor for a diagnosis. The following steps occur during the diagnostic process:
A complete exam will be done, and the doctor will look for any noticeable deformity.
They are used to view the fracture and see if a bone has been displaced.
Magnetic resonance imaging (MRI)
This type of test provides a more detailed examination and can generate detailed images of internal bones and tissues.
Bone scans, computed tomography (CT), and others may be ordered to make a more accurate diagnosis and judge the severity of the fibula fracture.
Treatment for a fibula fracture can vary and largely depends on the severity of the break. A fracture is classified as either open or closed.
Open fracture (compound fracture)
Simple and compound fibula fractures are classified according to whether the skin has been broken or the bone is exposed.
In an open fracture, the bone goes through the skin and a deep wound can be seen exposing the bone through the skin.
Open fractures are often the result of high-energy trauma or a direct blow, such as a fall or a motor vehicle collision.
This type of fracture can also occur indirectly, as with a high-energy type of twisting injury. The force required to cause these types of fractures means that patients will often receive additional injuries.
Some injuries could be life threatening. According to the American Academy of Orthopedic Surgeons, there is a 40 to 70 percent rate of associated trauma to other parts of the body.
Doctors will treat open fibula fractures immediately and look for other injuries. Antibiotics will be given to prevent infection. A tetanus shot will also be given if needed.
The wound will be thoroughly cleaned, examined, stabilized, and then covered so that it can heal.
Open reduction and internal plate fixation and screws may be necessary to stabilize the fracture.
If the bones do not join, a bone graft may be necessary to promote healing.
Closed fracture (simple fracture)
In a closed fracture, the bone is broken, but the skin remains intact.
The goal of treating closed fractures is to put the bone back in place, control pain, give the fracture time to heal, prevent complications, and restore normal function.
Treatment begins with the elevation of the leg. Ice is used to relieve pain and reduce swelling.
If surgery is not needed, crutches are used for mobility and an orthopedic brace, cast, or walking is recommended while healing takes place.
Once the area has healed, people can stretch and strengthen weakened joints with the help of a physical therapist.
There are two main types of surgery if a patient requires them:
- Closed reduction involves realigning the bone to its original position without the need to make an incision at the fracture site.
- Open reduction and internal fixation resets the fractured bone to its original position using hardware such as plates, screws, and rods.
The ankle will be placed in a cast or fracture boot until the healing process is complete.
Rehabilitation and physical therapy for fibula fractures
After being in a cast or splint for several days or weeks, most people find that their leg is weak and their joints stiff.
Most patients will need physical rehabilitation to ensure that their leg regains full strength and flexibility.
Physical therapy may be required to regain full strength in a person’s leg. A physical therapist will evaluate each person individually to determine the best treatment plan.
The therapist can take various steps to judge the individual’s condition. Measurements include:
- Range of motion.
- Surgical evaluation of scar tissue.
- How the patient walks and supports weight.
Physical therapy usually begins with ankle strengthening and mobility exercises.
Once the patient is strong enough to put weight on the injured area, walking exercises are common.
Balance is a vital part of regaining the ability to walk without assistance. Rotary table exercises are a great way to work out in a balanced way.
Many people are given exercises that they can do at home to help them with the healing process.
Long term recovery
Proper treatment and rehabilitation supervised by a doctor increase the chances that the person will regain strength and movement.
To prevent fibula fractures in the future, people who participate in high-risk sports should wear the appropriate safety equipment. People can reduce their risk of fracture by:
- Wear appropriate footwear.
- Follow a diet full of calcium-rich foods like milk, yogurt, and cheese to help build bone strength.
- Do weight lifting exercises to help strengthen your bones.
Prevention of fibula fractures
To prevent fibula fractures, people must be careful and aware when engaging in any physical activity, such as sports, or even some normal daily activities that lead to accidents.
Children must be provided a safe environment to work, study, or play. Possible dangers must also be anticipated and appropriate safety measures taken.
Some ways to help prevent unwanted injuries or fractures of the fibula include:
- People who participate in high-risk sports, such as soccer, should wear appropriate safety equipment to help prevent the possibility of a fibular fracture.
- Wearing appropriate footwear (such as the proper size of footwear) can help prevent accidents.
- Eating foods rich in calcium, such as milk, yogurt, and cheese, helps build bone strength. A regular diet with adequate calcium intake is recommended, even after a fracture.
- For women, the recommended amount of calcium increases with age and menopause.
- Perform weight lifting exercises to strengthen your bones.
Fractured fibulae generally heal without further problems, but the following complications are possible:
- Degenerative or traumatic arthritis.
- Abnormal deformity or permanent disability of the ankle.
- Prolonged pain
- Permanent damage to the nerve and blood vessels around the ankle joint.
- Abnormal torsion of pressure within the muscles around the ankle.
- Chronic swelling of the limb.
Most fibula fractures do not present serious complications. Within a few weeks to several months, most patients make a full recovery and can continue their normal activities.