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A fracture of the fibula bone in the lower leg can occur in a number of ways. It can be the result of a direct trauma or impact to the leg or ankle. Stress fractures can also occur, which are the result of repetitive impacts or muscle forces.
Fibula fractures are often thought to not be as severe as a fracture of the larger shin bone or Tibia. The Fibula is smaller and not a weight bearing bone like the tibia. Its purpose is to provide an attachment surface for the muscles.
It is possible an athlete can continue to compete on a broken fibula as in the case with American athlete Manteo Mitchell who completed the first leg of a recent Olympic 4x400m heat in a split time of 45 seconds, having broken his fibula within the first half of the race!
The Fibula is the smaller of the two shin bones, on the outer part of the lower leg. It can be felt as the bony lump on the outside of the ankle (malleolus), which is a common area for a fracture to occur. The bone travels up the outer lower leg to the outer knee, where the head of the fibula can be felt just below the knee on the outside.
There are two types of Fibula fracture that can occur - a direct trauma fracture or a stress fracture. Both are self-explanatory in their causes and very painful.
Traumatic fractures of the Fibula occur most regularly in association with an ankle sprain, where part of the bone is pulled away with the ligament. This is known as an avulsion fracture. They may also occur due to a direct impact to the outside of the lower leg. A fracture to the malleolus may also be known as a Pott's fracture.
Stress fractures of the Fibula do sometimes occur, although these are far less common than stress fractures to the Tibia, as the Fibula is not a load bearing bone. They are more likely to be caused by repetitive muscle traction forces. The fibula is the base for many muscles to attach to, including the peroneal muscles and the biceps femoris hamstring muscle.
The terminology used varies, but it should be noted that a broken bone is the same as a fractured bone. A fracture may be full, partial or hairline, but are all referred to as a fracture.
If you suspect you may have a fibula fracture, it is important to visit a sports injury specialist or a Doctor as soon as possible. They will be able to assess the injury to determine if they think this is likely.
If they do, you will be referred for an X-ray (asap) to confirm the injury and also the extent of the fracture. Further scans such as bone scans or MRI's may be requested in more complicated cases.
Treatment of a fibula fracture depends largely on the severity of the injury. Stress fractures require only a short period of non-weight bearing, followed by relative rest and non-weight bearing activity for 6-8 weeks.
Acute fractures may require casting to immobilise the ankle, although as the fibula is a non-weight bearing bone, this may not be necessary. A period of non-weight bearing using cructhes may be sufficient.
In more severe injuries, especially those around the ankle, casting may be required to immobilise the joint. The cast is kept in place for 4-6 weeks whilst the bone heals.
Severe injuries with extensive soft tissue damage, displacement of the fracture or multiple fracture may require surgery to internally fixate the bones with screws and plates or rods. After this, non-weight bearing is required for several weeks.
However severe the fibula fracture is, rehabilitation following the injury is essential and should not be ignored. Ensure you regain full range of motion at the ankle joint, which usually requires extensive calf stretching exercises. Sports massage may also help with this.
Developing strength in the lower leg muscles (in the calf, shin and peroneals) is important, as is working on the proprioception of the ankle joint, as this is diminished after such an injury. Wobble boards are great for this!
Peroneal strengthening for fibula fractures: