Fibular fracture

The fibular fracture is a common injury and refers to the fracture of the smallest tubular bone in the leg: the fibula, also called fibula.

There are several ways in which this bone located in the lower part of the leg can break.

A fibula fracture can occur as a result of direct force on the leg or ankle or the cause lies in stress, i.e. the bone is repeatedly exposed to impact trauma and forces.

Fibula fractures are classified as less serious than a fracture of the shin.

The fibula is smaller and does not have to carry body weight; one hears again and again of cases in which a player continues to play with a broken fibula.
This is painful but possible because the shin carries the body weight.


Causes of fibular fracture

Fibula fractures without further injuries to the ankle

Isolated fractures of the fibula, if the ankle joints are uninjured, are usually treated by simple immobilization. The fracture of the outer ankle (malleolus lateralis) occurs with sprain of the ankle or unfortunate tripping, while the inner ankle (medial muscle) remains intact.
In these cases, a bandage to support the ankle is sufficient. For a few days or weeks, forearm crutches are used to allow swelling and pain to subside.
When the pain subsides, rehabilitation can begin, during which mobility, muscle strengthening and walking exercises are performed.

Ankle fractures involving the shin, fibula and possibly deltoid ligament usually require more intensive treatment.
In this type of fracture, also known as bimalleolar fractures, surgical treatment is usually necessary to stabilize the ankle.
Without surgical care, the ankle can grow crooked and later develop arthritis.

Another type of injury that can occur along with a fibula fracture is injury to ankle syndesmosis.
Syndesmosis or ligament is a form of fake joint, instead of joint cavity and articular cartilage, the bone segments are held together by a membrana interossea or ligaments.
If the syndesmosis of the ankle joint is damaged, surgical intervention is usually necessary to restore the bones correctly.

Fibula fracture with fracture of the shin shaft (lower leg fracture)

In the case of serious injuries caused, for example, by traffic accidents, sports accidents and falls, both the shin and fibula above the ankle joint can break.
In these cases, surgical treatment must be carried out so that the leg can be brought back into a correct anatomically appropriate position.
If the shin has been surgically treated, the fibula usually does not need a separate procedure for bone setup. In some cases, a long plaster cast extending from the thigh to the foot is sufficient for combined shin and fibula fractures, which provides sufficient support for the leg even without surgery.
Fatigue fractures
Fatigue fractures, also called stress fractures, are caused by continuous microtrauma that repeatedly causes microfractures in the bone.
In some cases, the fibula can break in this way, especially marathon runners and hikers.
The pain caused by fatigue fractures can develop gradually.
Usually, the pain becomes stronger during activity and decreases at rest.

Signs and symptoms of fibula fracture

Anyone who suffers a fibula fracture will feel a sudden, intense pain on the outside of the ankle or down of the leg during the injury. The patient can not load the injured leg and limps.
The pain can also subside quickly; What remains are complaints that become stronger at night or in the morning when getting up.
With a fibular fracture, swelling and bruising may occur and pain may occur when the affected area is touched. The pain intensifies with certain movements of the foot, ankle and knee joint or when walking and standing.
With severe fractures of the fibula, a clear deformity is visible.


Physical examination: Look for swelling (edema), bruising (hematomas) and discomfort in the fracture area.
Depending on the exact point of fracture, swelling and restriction of the range of motion from the knee to the ankle may occur.
In the case of an open fracture, there is a skin injury.
A thorough examination of the nerves, blood vessels and muscles of the legs is important to determine the treatment method and to be able to make a prognosis.

Technical examinations
The diagnosis of a calf or tibia fracture can be made by taking an X-ray.
Depending on the fracture site, X-rays of the knee and ankle may also be necessary.
CT and MRI (magnetic resonance imaging) are rarely used, actually only if the fracture extends into the knee joint.

As a rule, fatigue fractures cannot be detected on the X-ray image in the first few weeks; the doctor therefore prescribes a bone scintigraphy in some cases, which indicates the stress fracture already in the initial phase.
If impaired blood circulation is suspected, an angiogram can be made. The preparation of the complete blood count, typing of the blood (blood sampling and entry into the bank of bone marrow donors), blood coagulation tests and electrocardiogram (ECG) are part of the routine of surgery.
Whether further laboratory tests need to be carried out depends on the extent of the injuries and other pathologies associated with the fracture.

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