Fibula Fracture

A fracture of the fibula bone in the lower leg can occur as a result of a direct trauma or impact to the leg or ankle, or a 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.

Fibula fracture symptoms

Fibula fractures can be acute or happen suddenly or they can come on over time as in a stress fracture.

Acute (traumatic) fibula fractures

Fibula fractureSymptoms include a sudden acute pain in the lower leg with rapid swelling. The athlete will most likely limp or be unable to bear weight on the fractured leg. There will be tenderness around the site of the fracture and most likely deformity of the lower leg. In a severe case there will be deformity where the bones have displaced.

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.

Fibula stress fracture symptoms

Symptoms of fibula stress fractures tend to include a  gradual build up of pain on the outer leg which eases with rest and increases with activity. It may be tender over the point of the fracture and there may be aching or throbbing pain at night. See fibula stress fracture for more detailed information.

Fibula fracture explained

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 called the lateral malleolus, which is a common area for a fracture to occur. The bone runs up the outside of the lower leg to the 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.

Potts fractureTraumatic 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 as the fibula is where many muscles to attach to.

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.

Treatment of a fibula fracture

Plaster cast

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 immobilize the ankle, although as the fibula is a non-weight bearing bone, this may not be necessary. A period of non-weight bearing using crutches 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.

Calf exercisesHowever 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!