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Fracture of the fibula
Last reviewed: 07.06.2024
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A fracture of the fibula (or lateral fibula fracture) is an injury to the lower part of the tibia (in anatomical terms, this is the fibula) in the thigh or lower leg. This bone is parallel to and supports the larger tibia (or tibia).
Fractures of the fibula can be caused by a variety of injuries or forces, including:
- Injuries and impacts: A fracture can occur as a result of a blow, fall, or accident.
- Sports Injuries: Injuries leading to a fracture of the fibula can occur in sports activities.
- Acute trauma: For example, a car accident can cause a fracture of the fibula.
- Overstress injuries: Prolongedstrain or excessive stress on the bone can lead to a fracture.
Symptoms of a fracture of the fibula may include pain, swelling, bruising, and limited mobility in the area of the injury. Diagnosis usually involves x-rays to determine the nature and location of the fracture.
Treatment of a tibia fracture depends on the nature of the injury. Many tibia fractures can be treated conservatively with a cast or other fixation device to stabilize the bone. In some cases, surgery may be required to repair the bone and fix it with special plates or nails.
After treatment, it is important to follow the doctor's recommendations and rehabilitative measures to restore function to the leg.
Causes of the fracture of the fibula
A fracture of the fibula can be caused by a variety of factors or situations that create forces or injuries that cause this bone to break. Some of the causes of a fracture of the fibula include:
- Injuries and impacts: Fractures of the tibia are often caused by trauma such as falls, impacts, car accidents, and sports injuries. A blow or forceful impact to the side or front of the leg can result in a fracture of the fibula.
- External forces: Exposure to external forces, such as severe compression of the leg or stretching of muscles and tendons, can also cause a fracture of the fibula.
- Sports injuries: In some sports, especially soccer, hockey, basketball and other contact or active disciplines, there is a risk of fractures of the fibula.
- Overexertion injuries: Prolonged exertion and repetitive movements such as running or jumping can increase the risk of tibial fracture.
- Osteoporosis: In people with osteoporosis, who have less dense bones, a fracture of the fibula can occur with even minimal trauma or falls.
- Other medical conditions: Some medical conditions, such as bone cancer or defects in bone structure, may increase the risk of fracture.
Symptoms of the fracture of the fibula
Below are the main signs and symptoms of a fractured fibula, as well as potential complications:
Symptoms and signs of a fracture of the fibula:
- Acute pain: Severe and sharp pain at the fracture site, which may be worse when trying to move the leg or applying pressure.
- Swellingand swelling: There is swelling and swelling around the fracture site.
- Redness: Inflammation can cause redness of the skin over the fracture site.
- Deformity: Visible deformity of the leg may be seen when the bones are displaced.
- Bruising(hematoma): The appearance of bruising or bruising in the area of a fracture.
- Inability to support theleg: The patient has difficulty supporting the affected leg and walking because of the pain and instability of the fracture.
- Weakness and numbness: Weakness or numbness may occur due to nerve or blood vessel damage.
Complications may include:
- Infection: Internal or external infection may occur due to an open fracture or during surgical treatment.
- Delayed healing or improper fusion: Bones may not heal properly or may be delayed in the healing process.
- Osteomyelitis: This is a serious complication in which an infection of the bone occurs.
- Vascular and Nerve Damage: A fracture can damage blood vessels or nerves in the area of the fracture, which can lead to impaired circulation and sensation.
- Osteoarthritis: The effects of a fracture can cause osteoarthritis to develop in the tibia.
The healing time of a fracture of the fibula can vary depending on several factors, including the nature of the fracture, the method of treatment, and the individual patient. On average, the healing process takes about 6-8 weeks, but this is only an estimate and can be short or long.
Here are a few factors that affect the rate of healing of a fracture of the fibula:
- Thenature of the fracture: Simple fractures without displacement usually heal faster than compound fractures with displaced bone fragments.
- Treatment: Conservative treatment with fixation with a plaster splint or therapeutic shoes may take longer to heal than surgical fixation.
- Patient Age: Younger patients tend to heal faster because their bodies are able to heal bones more efficiently.
- Health Status: The patient's general health, presence of chronic diseases, or nutritional deficiencies can also affect the rate of healing.
- Adherenceto recommendations: Following all of your doctor's recommendations, including physical therapy and rehabilitation, can speed up the healing process.
It is important to emphasize that the healing process of a fracture can be individualized for each patient. Therefore, the doctor will monitor the healing process and recommend the necessary measures for optimal recovery. If concerns or complications arise during the healing process, it is important to seek medical attention in a timely manner.
Swelling after a fracture of the fibula is quite common and can occur due to several factors related to the injury and its effects. Here are some of the main causes of swelling after a fracture:
- Inflammation and tissue damage: A fracture is accompanied by inflammation in the area of injury. This inflammation can cause swelling as the body begins to release fluid and proteins into the tissues to fight inflammation.
- Vascular changes: Thevascular damage and bleeding that often accompanies a fracture can lead to swelling.
- Immobilization: Fixing the fracture with a cast or other supportive devices may cause some swelling due to limited mobility and slow blood flow.
- Lymphatic Outflow: A fracture can damage lymphatic vessels, which affects the body's ability to remove excess fluid from tissues, which can also lead to swelling.
To reduce swelling after a tibial fibula fracture and promote faster recovery, you can take the following steps:
- Elevate thelimb: Elevating the injured leg above the level of the heart can help reduce swelling.
- Ice application: Applying ice to the injury site during the first 48 hours after a fracture can reduce inflammation and swelling. However, ice should be wrapped in a cloth or towel and never applied directly to the skin.
- Physical Therapy: Physical therapy and exercise in the early stages of recovery can help improve circulation and lymphatic outflow, which helps reduce swelling.
- Adherence to doctor's orders: It is important to follow all doctor's recommendations regarding treatment and physical activity to prevent complications.
If the swelling remains for a long time or worsens, a physician should be consulted for further evaluation and management of the condition.
Stages
The severity of a fracture of the fibula can range from minor to severe, depending on the characteristics of the fracture itself. The severity of the fracture is assessed based on several factors, including:
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Displaced fracture:
- Minor displacement: The bone fragments remain in close contact with each other.
- Moderate displacement: Bone fragments may shift slightly, but not significantly.
- Severe displacement: The bone fragments have become widely separated from each other and do not remain in their normal position.
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Number of fragments:
- Simple fracture: Bone fractured into two fragments.
- Multiple fractures: Bone fractured in more than two fragments.
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Thepresence of an open fracture:
- Closed fracture: The skin over the fracture site remains intact.
- Open fracture: The bone penetrates the skin, which can increase the risk of infection.
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Thecondition of the surrounding tissues:
- Damage to surrounding muscles, vessels, or nerves can increase the severity of the fracture and the need for surgery.
Based on these factors, a fracture of the fibula can be categorized as:
- Simple closed fracture (minor to moderate displacement without damage to surrounding tissues).
- Complex closed fracture (severe displacement or multiple fragments without damage to surrounding tissues).
- Open fracture (a fracture with skin damage and possible complications).
Severe fractures may require surgical treatment, while less severe fractures may be treated conservatively, such as plaster splint fixation. The exact severity and method of treatment will be determined by a physician after diagnosis and evaluation of the patient's condition.
Forms
A fracture of the fibula (fibula) can occur with different characteristics, including the presence or absence of displacement. It is important to know what form of fracture you or someone you know has in order to properly assess its severity and treatment requirements.
- Non-dislocated tibial fracture: In this case, the bone is fractured, but its fragments remain in their normal anatomical position without displacement. Such fractures can usually be treated conservatively by wearing a plaster cast or orthosis, which helps stabilize and protect the fracture site. Patients may be prescribed physical rehabilitation to regain strength and mobility in the leg after the cast is removed.
- Fracture of the fibula with displacement: In this case, the bones are displaced and do not stay in their normal position. This type of fracture requires more serious attention and treatment. Repositioning, which means restoring the bones to their correct position, will often be required, often through surgery. This may then require fixation of the bones using plates, screws, or other fixation devices. Treatment may also include post-operative physical therapy and rehabilitation.
The fibula (fibula) can be susceptible to both closed and open fractures:
- Closed fracture of the tibia: In a closed fracture, the bones are destroyed or cracked, but the skin and soft tissues above the fracture remain intact. The characteristic symptom of a closed fracture is pain, swelling, and possibly bruising at the fracture site. X-rays may be required to diagnose such a fracture.
- Open (open) fracture of the fibula: In the case of an open fracture, the skin over the fracture is damaged and the bone may even penetrate through the wound to the outside. This is a more serious condition as it increases the risk of infection and other complications. Treatment for an open fracture includes not only stabilizing and aligning the bone, but also careful examination and treatment of the wound and prevention of infection. Open fractures often require surgery and a longer recovery period.
A fracture of the head of the fibula, also known as a tibial neck fracture (femoral neck fracture), and a fracture of both the tibia and fibula (femur fracture) are serious conditions that require careful evaluation and treatment by doctors and medical professionals.
- Fracture of the head of the fibula (femoral neck): This type of fracture is common in older adults and may be caused by osteoporosis or trauma. A femoral neck fracture may be characterized by hip pain, inability to stand or walk, and shortening of the leg. Treatment usually involves surgical repositioning (restoring the position of the bone) and fixation with bolts, plates, or nails, as well as rehabilitation to restore mobility and strength.
- A fracture of both the tibia and fibula (femur fracture): This type of hip fracture is more serious and rare. It usually occurs as a result of severe trauma, such as a car accident or a fall from a height. Treatment for this type of fracture also requires surgical correction and fixation, and recovery can be long and intense.
Diagnostics of the fracture of the fibula
Diagnosing a fracture of the fibula (fibula) usually involves several steps and methods that help doctors determine the type, location, and nature of the fracture. Here are the basic diagnostic methods:
- Clinical Examination: The physician begins by examining and evaluating the area of injury. He or she looks for signs of pain, swelling, hemorrhage, deformity, and changes in the position of the leg or foot. The clinical examination can give a preliminary idea of whether a fracture is possible.
- Radiography: Radiography is the standard method of diagnosing fractures. X-rays can be taken in multiple projections to better characterize the fracture such as type (transverse, longitudinal, displaced, etc.), location, and level of injury. Radiographs can also show whether fractures are accompanied by damage to neighboring bones or arteries.
- Computed tomography (CT) scan: In some cases, especially if the fracture is complex or if damage to adjacent structures is suspected, a CT scan may be required for more detailed imaging.
- Magnetic resonance imaging (MRI): MRI can be used to evaluate the soft tissues around the fracture and identify possible ligament, vessel, or nerve damage.
On an x-ray of a fractured fibula, you can expect the following characteristics to help your doctor determine the nature and extent of the fracture:
- Location of the fracture: An x-ray will show the exact location of the fracture on the tibia. This may be closer to the ankle (distal fracture), closer to the knee (proximal fracture), or in the middle of the bone.
- Displacement: X-rays can show if there is displacement of the bone fragments and how significant it is. A displaced fracture usually requires more serious treatment.
- Number of fragments: X-rays can also show how many fragments have formed as a result of the fracture. Multiple fragments may require more complex treatment.
- Type of fracture: X-rays help determine the type of fracture. It can be longitudinal, transverse, spiral, etc.
- Open or closed fracture: X-rays can also help your doctor determine whether a fracture is open (when the bone penetrates the skin) or closed (when the skin remains intact).
X-rays are an important tool for diagnosing a fracture and determining if treatment is needed. The doctor evaluates all of the above factors to decide on the best treatment option, whether it is conservative treatment (plaster splint) or surgery.
Treatment of the fracture of the fibula
Treatment of a tibial fibula fracture goes through several stages that include diagnosis, first aid, direct treatment, and recovery. Here is a detailed description of the stages of treatment:
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Diagnosis:
- A fracture of the fibula is usually diagnosed by x-ray. X-rays allow the doctor to determine the location, nature, and extent of displacement of the fracture.
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First Aid:
- If a fracture of the fibula is suspected, first aid should be administered, including:
- Do not move or put any weight on the injured limb.
- Try to stabilize the leg in the position it was in at the time of injury, such as fixing it with supportive devices, therapeutic shoes, or cushions.
- Apply ice to the site of the injury to reduce swelling and pain.
- If a fracture of the fibula is suspected, first aid should be administered, including:
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Treatment:
- Conservative treatment:
- If the fracture is stable and without displacement, a plaster splint or therapeutic shoes may be used for fixation.
- Physical therapy may be prescribed to strengthen muscles and restore mobility.
- Surgical treatment:
- If the fracture is displaced or unstable, surgery may be needed to repair the bone. The surgeon uses special tools and materials to fix and align the bone.
- Conservative treatment:
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Postoperative period:
- After surgery, the patient may require rehabilitation procedures and physical therapy to restore function to the leg.
- Measures are taken to prevent complications such as blood clots, dislocation of fixation, and infection.
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Restoration:
- After removal of the cast or recovery period after surgery, it is recommended that the patient continue physical therapy and exercises to regain muscle strength and mobility.
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Control and monitoring:
- The patient is scheduled for follow-up visits with the physician to assess healing progress and radiologic follow-up.
Treatment of a tibia fracture should be individualized and depends on the characteristics of the fracture and the patient's overall condition. Patients should strictly follow the recommendations of the physician and physiotherapist to ensure the best possible recovery.
Operation
Surgery to treat a fracture of the fibula may be required when the fracture is overly compound, crushed, coming out from under the skin, accompanied by damage to surrounding tissues, or when conservative treatment is ineffective.
The surgical procedure for a fracture of the fibula may include the following steps:
- Patient preparation: The patient undergoes preparation for surgery, including anesthesia and operating room preparation.
- Fracture repair: The surgeon uses tools and techniques to align and correct the displacement of the fracture. This may include fixing the bone with special plates, nails, or screws.
- Bone fixation: After the bone has been repositioned, it is fixed using surgical instruments. Fixation can be temporary (as with nails or splints) or permanent (using metal plates and screws).
- Wound closure: After fixing the bone, the surgeon closes the wound using sutures or sterile dressings.
- Rehabilitation: After surgery, the patient may be prescribed physical therapy exercises and rehabilitation activities to restore leg function and strengthen muscles.
- Post-operative care: The patient is given instructions on wound care, medications, and restrictions on daily activities during recovery.
Orthoses
Orthoses can be helpful during recovery from a tibial fracture. They help provide stability, support, and protection to the affected limb. Here are a few types of orthotics that can be used for tibia fractures:
- Plaster cast (plaster splint): This is a rigid orthosis worn in the first few weeks after a fracture. It fixes the leg in a certain position and prevents movement at the fracture site to help the bone heal.
- Plastic boot (walker): After the cast is removed, but before full recovery training, patients can use a plastic boot or walker to make walking easier and prevent strain on the affected leg.
- Orthotic Insoles: Orthotic insoles may be recommended by your doctor to provide proper support for the foot and reduce stress on the tibia during recovery.
- Elastic bandages: Elastic bandages or wraps can help reduce swelling and provide additional support.
- Orthopedic Shoes: After a period of wearing a cast or plastic boot, special orthopedic shoes may be required to provide proper support and comfort when walking.
- Lightweight Plaster Bandage (Air Cast): This is a lightweight orthosis that provides stability and protection, but allows for easier removal and donning for foot care and exercise.
It is important to consult with your doctor or orthopedist to choose the right orthosis and adjust it properly. He or she will also help you determine how long you should use it during the recovery process.
Recovery and rehabilitation
Recovery and rehabilitation after a tibia fracture play an important role in restoring full function to the leg. This process can take several weeks to several months, depending on the severity of the fracture. Here are some general guidelines and steps for recovery and rehabilitation:
- Fixation of the fracture: Depending on the type and position of the fracture, the doctor may decide to place a cast or other fixation material on the leg to provide stability and fusion of the bones. The patient should strictly follow the recommendations for wearing a cast and avoid putting stress on the affected limb.
- Medications: Your doctor may prescribe medications for pain and inflammation to ease discomfort during the healing period.
- Physical Therapy: Physical therapy may be required after removal of a cast or other fixation material. A physical therapist will help restore strength and mobility to the leg through special exercises and treatments.
- Strengthening exercises: The patient will be prescribed exercises to strengthen the muscles of the leg, including the lower leg and foot. This will help prevent muscle atrophy and return the leg to full function.
- Stretchingand Flexibility: Stretching andflexibility exercises can help restore normal range of motion in the joints of the tibia and ankle.
- Gradual exercise: It is important to start exercising the affected leg gradually and under the supervision of a specialist. This includes walking with support (e.g. Crutches), then unsupported and eventually returning to normal activity.
- Proper footwear and support devices: Your doctor or physical therapist may recommend proper footwear and support devices, such as orthotic insoles or special shoes, to provide proper support and reduce stress on your foot.
- Following yourdoctor's recommendations: It is important to follow your doctor's and physical therapist's instructions and to perform exercises and rehabilitation procedures in a regular and disciplined manner.
- Psychological support: The injury and fracture can affect the patient's mental state. Support from a psychologist or psychiatrist can be helpful in managing stress and anxiety.
- Adhere to a healthy lifestyle: A healthy diet, moderate physical activity and avoiding bad habits such as smoking will help speed up the recovery process.
It is important to discuss all phases of recovery and rehabilitation with your doctor and physical therapist to develop an individualized treatment plan that fits your condition and needs.
Exercises after a fracture of the fibula
After a tibia fracture, it is important to do exercises and physical rehabilitation to restore strength, mobility and function to the leg. However, you should only begin exercises after authorization from your doctor or physical therapist. Below is a list of exercises that may be helpful in recovering from a tibia fracture:
- Shin flexion and extension: Lying on your back, bend and extend your big toe up and down. This strengthens the muscles of the lower leg.
- Foot rotation: Lying on your back, rotate your foot around the axis as if you were drawing circles in the air. This helps to restore mobility to the ankle.
- Ankle Flexibility: Sitting in a chair or on a bed, move your foot up and down, trying to maximize ankle flexion and extension.
- Balance exercises: Standing on one leg, try to stay balanced for 30 seconds or more. Gradually increase the time. This helps you regain stability and coordination.
- Exercises for the thigh muscles: Lying on your back, bend your leg at the knee and lift your thigh off the floor. Then slowly lower it. Repeat the exercise several times.
- Exercises for buttock muscles: Lying on your back, bend your leg at the knee and lift your buttock off the floor. Then slowly lower it. Repeat the exercise several times.
- Foot Pump: Sitting on a chair, move your foot up and down as if you were pedaling a bicycle.
- Walking: Start with short walks on a flat surface, using a support if necessary. Gradually increase distance and decrease dependence on support.
- Strengthening and coordination exercises: A physical therapist may prescribe specialized exercises to strengthen muscles and improve coordination of movement.
- Stepper or exercise bike: If you have access to exercise equipment, you can use a stepper or exercise bike with guidance.
It is important to follow the instructions of the physiotherapist and perform the exercises regularly. Do not exaggerate the load and be aware of how you feel. If you experience pain or discomfort during exercise, stop immediately and tell your doctor or physiotherapist.
Forecast
The prognosis of a tibia fracture depends on several factors, including the nature of the fracture, method of treatment, age and general condition of the patient. In most cases, with timely and proper treatment, a fracture of the fibula has a good prognosis and the patient makes a full recovery. However, it is important to consider the following factors:
- Nature and displacement of the fracture: Simple fractures without displacement and minor displaced fractures have a more favorable prognosis than complex fractures with severe displacement.
- Treatment: Conservative treatment, such as plaster splint fixation, often has a good prognosis, especially for minor fractures. Surgery may be necessary for compound or displaced fractures.
- Patient's age: Younger patients have a higher bone healing capacity, so they usually have a better prognosis.
- General condition of the patient: The presence of other medical conditions, such as diabetes or blood diseases, can affect the body's ability to heal.
- Adherence to recommendations: It is important that the patient follows all of the doctor's recommendations, including physical therapy and rehabilitation, for optimal recovery.
- Possible complications: In some cases, complications such as infection, impaired healing, or dislocation of fixation may occur, which may worsen the prognosis.
In general, with proper treatment and rehabilitation, most patients successfully recover from a fractured fibula. However, each case is unique and the prognosis should be evaluated by a physician on an individual basis. Patients should carefully follow the doctor's recommendations and rehabilitation measures to speed up and improve the recovery process.