A fractured fibula is a break in the fibula, the smaller of the two long bones in the lower leg, running parallel to the tibia. This common orthopedic injury often results from sudden trauma that stresses the limb beyond its capacity. A fracture can range from a hairline crack (a stress fracture) to a complete break where the bone is separated into two or more pieces. The injury is frequent among athletes due to high forces involved in sports, but it can also occur from simple falls or accidents.
Anatomy and Common Causes of Injury
The fibula is located on the lateral, or outer, side of the lower leg, extending from below the knee to the ankle. Unlike the tibia (shin bone), which bears most of the body’s weight, the fibula primarily provides stability to the ankle joint. It also serves as an attachment point for various muscles that aid in ankle and foot movement. Because it is slender and not a major weight-bearing structure, an isolated fibula fracture may sometimes allow a person to walk, depending on the break’s location.
The most frequent mechanism of injury involves a severe twisting motion, such as rolling the ankle during a fall or a sports maneuver like skiing or basketball. This twisting often results in a fracture at the distal end, forming part of what is commonly known as a broken ankle. A direct impact, like a forceful blow to the side of the leg from a car accident or a tackle in football, can cause a mid-shaft fracture. Repetitive stress from activities like long-distance running or marching can also lead to tiny cracks in the bone, known as fibular stress fractures.
Signs and Symptoms of a Fibula Fracture
A fibula fracture typically causes sharp, intense pain localized to the outer side of the lower leg or ankle. This pain usually worsens significantly when attempting to put weight onto the injured leg. Swelling and bruising around the site of the break are almost universally present, developing rapidly as blood vessels rupture. The area may appear visibly distended and tender to the touch.
Difficulty or the complete inability to bear weight is a frequent sign, though the extent depends on whether the ankle joint’s stability is compromised. If the fracture is displaced, a visible deformity or unnatural bend in the lower leg may be apparent. Even if symptoms seem less severe, such as a dull ache that worsens with activity, seeking immediate medical attention is necessary to determine the injury’s extent and prevent complications.
Diagnosis and Treatment Options
Diagnosis begins with a physical examination, assessing the pain location, swelling, and ankle joint stability. Standard X-rays are the primary tool used to confirm a fibula fracture and show the alignment of the fragments. For complex cases, such as evaluating soft tissue damage or joint surface involvement, a Computerized Tomography (CT) scan or Magnetic Resonance Imaging (MRI) may be used.
Treatment is based on the fracture’s location and stability, specifically whether it is displaced or non-displaced. Non-surgical management is used for stable, non-displaced fractures where bone fragments remain in good alignment. This conservative approach begins with the RICE protocol (rest, ice, compression, and elevation) to manage initial pain and swelling. The limb is then immobilized using a short leg cast, splint, or a removable walking boot, often for four to six weeks.
Surgical intervention, specifically Open Reduction Internal Fixation (ORIF), is required for displaced or unstable fractures. This is especially true for injuries that compromise ankle joint stability or involve the syndesmosis (the ligamentous structure connecting the tibia and fibula). During ORIF, the surgeon realigns the bone fragments through an incision (open reduction). The fragments are then held securely in place with metal hardware, such as plates, screws, or rods (internal fixation).
Recovery Timeline and Rehabilitation
Bone healing for a fibula fracture typically takes six to eight weeks, though full recovery and return to activity can range from three to six months. Following non-surgical treatment, a patient may begin partial weight-bearing with a walking boot within the first one to two weeks. Post-surgical recovery often requires a period of strict non-weight-bearing for approximately six weeks to protect the hardware and allow initial bone fusion.
Physical therapy (PT) is an important component of the recovery process after the initial immobilization period is complete. The early focus of rehabilitation is on restoring the ankle’s range of motion, which is often limited after weeks of disuse. This is followed by strengthening exercises targeting the muscles of the calf and ankle to regain stability and power. A physical therapist will also guide the patient through gait training, helping to restore a normal walking pattern and improving proprioception.