Lower leg fractures can occur from trauma, falls, sports injuries or overuse. Fractures of the fibula bone -- the smaller of the two bones of the lower leg -- can be minor hairline cracks or severe enough to interfere with your ability to bear weight and walk. Treatment for fibula fractures depends on the severity of the injury.
Immobilization and Rest
Stress fractures of the fibula -- microfractures caused by repetitive stress, rather than sudden force -- are treated with immobilization and rest. These fractures are caused by repetitive activities, such as running. They typically affect the bottom of the fibula, the large prominence on the outside of the ankle. However, in rare cases, they can occur at the top of the bone near the knee, particularly with repetitive jumping activities. Fibula stress fractures may be casted or splinted. Crutches are often used to reduce pain with walking for 1 to 2 weeks until you are able to bear full weight on your leg. Activities are generally resumed as pain decreases, under the specific guidance of your doctor.
Closed reduction describes realignment of the ends of a broken bone without surgery. If the broken ends are close to their proper position, an orthopedic doctor uses her hands to realign the broken ends of your fibula bone to allow it to grow back together. A cast may be applied to keep the bones in place as they heal. The fibula is not a weight-bearing bone, and your doctor may allow you to walk on the injured leg while it is healing. However, the fibula contributes to ankle stability, and you may have to use crutches to avoid putting weight on the leg until the bone is healed. Many factors affect this decision, including your activity level, doctor's preference and the severity of your injury.
Fibula fractures may require surgery, particularly if the bone pieces have moved far out of alignment or if the bone has broken into multiple pieces. Internal fixation refers to a surgical procedure used to realign and mechanically stabilize a severely broken bone. A broken fibula may be stabilized with a screw or a plate and screws. K-wires -- flexible metal wires -- are also used to hold broken bones together to provide stability and allow them to heal.
In some cases, broken bones do not grow back together, a condition called nonunion. This can occur with the fibula bone, typically affecting the lower end of the bone where there is less soft tissue coverage and decreased blood supply. Nonunion can be treated conservatively with electrical stimulation and magnetic devices, or it may require surgery. The area of bone that was fractured may be removed or surgically stabilized with a plate. Bone grafting may be required to fill the space where the bone has not healed.
Reviewed by: Tina M. St. John, M.D.
- Canadian Journal of Surgery: Locked Plate Fixation of the Comminuted Distal Fibula -- A Biomechanical Study
- International Orthopaedics: Nonunion of Fibula -- A Systematic Review
- International Orthopaedics: Stabilisation of the Fractured Fibula Plays an Important Role in the Treatment of Pilon Fractures -- A Retrospective Comparison of Fibular Fixation Methods
- The Podiatry Institute: Management of Complex Fibular Fracture -- Double Plating of Fibular Fractures
- Archives of Orthopaedic and Trauma Surgery: Determinants of Outcome in Operatively and Non-Operatively Treated Weber-B Ankle Fractures
- Clinics in Orthopedic Surgery: Stress Fracture of the Proximal Fibula in Military Recruits
- Wheeless' Online Textbook of Orthopaedics: Lateral Malleolus Frx
- Clinics in Sports Medicine: Imaging of Stress Fractures in Runners