Fibula Fracture: Symptoms, Treatment, and More

Medically reviewed by Suzanne Falck, MD on April 4, 2017Written by Neel Duggal on April 4, 2017

Overview

The fibula helps stabilize and support your leg, body, ankle, and leg muscles. It runs parallel to the tibia, a larger bone that also forms the shin, and attaches the ankle and knee joint.

The fibula only carries 17 percent of the body’s weight. A fibula fracture happens when more pressure is put on the bone than it can handle.

Seek emergency medical attention if you think you might have a fracture, particularly if the fracture breaks skin and bone is visible.

X-ray of a fibula fracture

fibula

What are the types of fibula fractures?

Fractures and breaks refer to the same condition. Fibula fractures occur around the ankle, knee, and middle of the leg. There are different types of fractures, which can also affect treatment and recovery. These types include:

  • lateral malleolus fracture, a break around the ankle
  • fibular head fracture, a break near the knee
  • avulsion fracture, a fracture in which a small part of the bone gets pulled off
  • stress fracture, a hairline fracture due to repetitive injury
  • shaft fracture, a break that often affects the middle of the leg due to direct impact

Except for stress fractures, these fractures often occur due to a traumatic injury or more pressure placed on the bone than it can handle. This can happen when you roll your ankle, have a direct blow to the leg, fall, or experience sports-related trauma.

Learn more: What causes fractures? »

What are the symptoms of a fracture?

Other than pain and swelling, other signs of a fibula fracture include:

  • deformity in the lower part of the leg
  • tenderness and bruising
  • pain that gets worse when putting pressure on the leg
  • tingling or numbness, which usually happens if there is a neurovascular injury

Other joints and bones involved, such as the tibia, may also have symptoms.

Read more: First aid for broken bones and fractures »

How will a doctor diagnose a fracture?

See a doctor if you have symptoms of a fracture, especially after a traumatic injury. Your doctor will physically examine you for signs and may order an X-ray, which will show the break. For fractures that need more precise imaging, your doctor may order a CT scan to see how severe the injury is.

Types of treatment for a fracture

Treatment depends on how severe the fracture is, the type, and where the injury is. Fractures are often categorized as closed (skin is intact) or open (skin is broken).

Whether closed or open, after your doctor aligns your bones, they’ll place your leg in a cast or splint. This prevents movement so the fracture can heal. You may get crutches. A physical therapist can teach you how to walk without putting weight on the broken leg.

Closed (simple) fracture treatment

Closed fractures may or may not need surgery. A splint or cast that prevents movement is usually all that is needed unless there are other parts of the leg that are also injured.

If you do require additional treatment to realign your bones, your doctor may recommend:

  • closed reduction: Your doctor realigns ends of a broken bone without cutting into your skin.
  • open reduction: Your doctor does invasive surgery on bones that may have broken in more than two places.
  • nonunion: Nonunion can be surgical or noninvasive, and it’s done when the ends of a fractured bone don’t heal together. When surgery isn’t needed, your doctor will usually use electrical and magnetic stimulation devices along with bone grafting.

Open (compound) fracture treatment

Seek emergency medical attention if you have an open fracture. Follow the RICE principle while you wait for help: rest, ice, compression, and elevation. Open fractures require surgery as there may be additional injuries, such as skin loss and damage to arteries.

Your doctor will focus on:

  • cleaning the wound to avoid contamination and infection
  • stabilizing the wound to keep bones in place before surgery
  • getting imaging tests to see what type of surgery is needed
  • determining whether antibiotics are needed to prevent infection

During surgery, your doctor may use internal or external methods for fixing your fracture. For internal fixations, your doctor will place metal implants inside the broken bone to hold the fracture together while it heals. Severe open fractures require external fixations, where the metal screws or pins project outside the skin to keep the bones in place. This is usually done until you’re ready for internal fixations.

After surgery, you’ll get a cast to promote healing.

Read more: Bone fracture repair »

Recovery, rehabilitation, and outlook

Recovery and home care

The general process for healing a fibula fracture is immobilization with a splint or cast for several weeks, after which you might get a walking boot to help you walk. Recovery time depends on factors such as:

  • the severity of the injury and the presence of any other injury at the same time
  • your age
  • how well you can follow your doctor’s orders
  • whether or not you require surgery
  • the amount of time spent on physical therapy
  • any underlying conditions that may affect healing

During recovery, your doctor will schedule follow-up X-rays to make sure your bones are healing properly. Follow the activities outlined by your physical therapist and doctor to encourage recovery.

Fracture home tips

  • Rest the fractured bone and elevate it while it’s in the cast.
  • Use your crutches to avoid putting weight on your injury.
  • Consume a diet high in nutrients such as vitamin D, calcium, and zinc for bone recovery.
  • Make sure you’re getting enough calories and protein.
  • Perform upper body exercises using light dumbbells to strengthen the arms, chest, back, and shoulders.
  • Take a pain reliever and anti-inflammatory if needed to reduce pain and swelling.

Rehabilitation

After you take off your cast, you’ll be able to move your leg, but it may feel stiff and weak. Your doctor can recommend a physical therapist to help you regain strength and range of motion. Here are some safe exercises to try.

Fibula rehabilitation exercises

  • Ankle stretch: Stretch your injured leg out and wrap a towel around the arch of your foot. Holding it by the ends, pull the towel toward you. You should feel a gentle stretch at the top of your foot and the ankle. Keep your leg straight as you hold this position for 15 to 30 seconds. Repeat three times.
  • Ankle rotation: Sit and place your ankle over the opposite knee. Push your foot downward and rotate it gently to reduce stiffness.
  • Ankle flexibility: Sit down and stretch out your injured leg. Write the alphabet in the air with your big toe to promote flexibility.

Outlook

After an injury, it can take up to 12-16 weeks to make a full recovery. Your doctor will use X-rays to see how well your fracture is healing. They’ll also look to see when they can remove the screws, if you have them.

Remember to talk with your team of health providers if your symptoms get worse or if recovery is going slower than expected. It’s also important to take steps to reduce your risk for another injury or fracture. Having had one fracture can increase your risk for another.

What increases your risk for a fracture?

Research shows that the biggest risk factor of a fibula fracture is low bone mass. Low bone mass increases the amount of stress or trauma on the fibula.

Factors that reduce bone mass can also increase your risk for a fracture. These include:

  • smoking
  • being female (except for fractures near the ankle)
  • older age
  • playing contact sports, such as soccer and rugby
  • practicing sports with frequent direction changing, such as snowboarding

Prevention tips for fractures

Fracture prevention tips

  • Wear proper shoes, especially ones with ankle support, when exercising. Replace old shoes when necessary.
  • Exercise regularly to maintain strength and fitness.
  • Make sure you’re getting enough calcium and vitamin D in your diet.
  • Keep floors and hallways clear of clutter to prevent falls.
  • Use night lights at home.
  • Add grab bars to showers and railways near stairways, if needed.

With rest and rehabilitation, fractures generally don’t develop complications. They may increase your risk for another fracture in the same area, especially if you’re an athlete. While not all fractures are preventable, taking steps to reduce your risk can go a long way.

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