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LEG FRACTURE, FIBULA

General Information

DEFINITION--A complete or incomplete break in the fibula, the smaller of the two bones of the lower leg. Fractures of the fibula are not uncommon, and displacement is seldom severe. They sometimes accompany severe ankle sprains.

BODY PARTS INVOLVED

  • Fibula.
  • Soft tissue surrounding the fracture site, including nerves, tendons, ligaments and blood vessels. {248}

    SIGNS & SYMPTOMS

  • Severe pain at the fracture site.
  • Swelling of soft tissue surrounding the fracture.
  • Visible deformity if the fracture is complete and bone fragments separate enough to distort normal leg contours.
  • Tenderness to the touch.
  • Numbness or coldness in the foot if the blood supply is impaired.

    CAUSES

    Direct blow or indirect stress to the bone. Indirect stress may be caused by twisting, turning quickly or violent muscle contraction.

    RISK INCREASES WITH

  • Contact sports such as football, soccer or hockey.
  • History of bone or joint disease, especially osteoporosis.
  • Obesity.
  • Poor nutrition, especially calcium deficiency.

    HOW TO PREVENT

    Build adequate muscle strength and achieve good conditioning prior to exercise, athletic practice or competition. Increased muscle mass helps protect bones and underlying tissue.

    WHAT TO EXPECT

    APPROPRIATE HEALTH CARE
  • Doctor's diagnosis. Setting of the fracture is usually not necessary.
  • Self-care during rehabilitation.

    DIAGNOSTIC MEASURES

  • Your own observation of symptoms.
  • Medical history and physical exam by a doctor.
  • X-rays of injured areas, including the knee and ankle.

    POSSIBLE COMPLICATIONS

  • Pressure on or injury to nearby nerves, ligaments, tendons, muscles, blood vessels, or connective tissues.
  • Delayed union or non-union of the fracture.
  • Impaired blood supply to the fracture site.
  • Arrest of normal bone growth in children.
  • Shortening of the injured bones.
  • Prolonged healing time if activity is resumed too soon.
  • Proneness to repeated injury.

    PROBABLE OUTCOME

    It is impossible to predict exactly how long it will take for any fracture to heal. Variable factors include age, sex and previous state of health and conditioning. The average healing time for this fracture is 4 to 6 weeks. Healing is considered complete when there is no motion at the fracture site and when X-rays show complete bone union.

    HOW TO TREAT

    NOTE -- Follow your doctor's instructions. These instructions are supplemental.

    FIRST AID

  • Keep the person warm with blankets to decrease the possibility of shock.
  • Cut away clothing, if possible. Don't move the injured area to remove clothing.
  • Follow instructions for R.I.C.E., the first letters of REST, ICE, COMPRESSION and ELEVATION. See Appendix 1 for details.

    CONTINUING CARE

  • Setting the broken bone for a fibula fracture is usually not necessary. The tibia (the big bone adjacent to the fibula) provides immobilization.
  • Fibula fractures usually require only a snug, toe-to-knee cotton elastic bandage. If pain is severe, a walking plaster cast below the knee may be necessary for about 5 weeks.
  • After the bandage or cast is removed, use frequent ice massage. Fill a large Styrofoam cup with water and freeze. Tear a small amount of foam from the top so ice protrudes. Massage firmly over the injured area in a circle about the size of a softball. Do this for 15 minutes at a time, 3 or 4 times a day.
  • Apply heat instead of ice, if it feels better. Use heat lamps, hot soaks, hot showers, heating pads, or heat liniments and ointments.
  • Take whirlpool treatments, if available.

    MEDICATION

    Your doctor may prescribe:
  • Narcotic or synthetic narcotic pain relievers for severe pain.
  • Stool softeners to prevent constipation due to inactivity.
  • Acetaminophen (available without prescription) for mild pain after initial treatment.

    ACTIVITY

  • Actively exercise all muscle groups not immobilized. These muscle contractions promote fracture alignment and hasten healing.
  • Begin walking and light running when there is no pain or tenderness.
  • Resume normal activities gradually after treatment. Don't drive until healing is complete.

    DIET

    During recovery, eat a well-balanced diet that includes extra protein, such as meat, fish, poultry, cheese, milk and eggs. Increase fiber and fluid intake to prevent constipation that may result from decreased activity.

    REHABILITATION

  • Begin reconditioning the injured area after clearance from your doctor. Use ice massage for 10 minutes before and after workouts.
  • See section on rehabilitation exercises.

    CALL YOUR DOCTOR IF

  • You have signs or symptoms of a leg fracture.
  • Any of the following occur after surgery or other treatment: Signs of infection (headache, muscle aches, dizziness, or a general ill feeling and fever). Swelling above or below the bandage or cast. Change in skin color to blue or gray beyond the cast, particularly under the toenails. Numbness or complete loss of feeling below the fracture site. Nausea or vomiting. Constipation.
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