Fibular Fracture

What is Fibular Fracture

A fibular fracture is a break (fracture) in the smaller of the two lower leg bones (fibula). The fibula is on the outer side of the lower leg.

What are the causes?

Fibular fractures are often caused by an injury from:

• High-contact sports, such as football, soccer, or rugby.
• Sports with lateral motion and jumping, such as basketball.
• Downhill skiing and snowboarding.

What are the signs or symptoms?

Symptoms of this condition include:

• Moderate to severe pain in the lower leg.
• Tenderness and swelling in the leg or calf.
• Trouble walking or bearing weight on the injured leg. Your child may limp.
• Change in shape of the outer leg.
• Pain during activity. The pain gets better with rest.

How is this diagnosed?

This condition is diagnosed with a physical exam and an X-ray. A CT scan may also be done.

How is this treated?

Treatment for this condition depends on the severity of the fracture. All fractures require rest and support from a boot, cast, brace, or splint. If the bone is broken into several pieces or if it is broken and out of place, surgery may be needed to place a rod, plate, or screws in the bones in order to fix the fracture. After surgery, the leg is protected in a cast or splint.

Pain and inflammation are treated with ice, medicines, and elevation of the leg. Your child may be given crutches to use while he or she is healing. Your child’s health care provider may also recommend exercises to strengthen muscles in your child’s ankle or leg and to restore motion (physical therapy).

Follow these instructions at home:

If your child has a splint, brace, or walking boot

• Have your child wear the splint, brace, or boot as told by your child’s health care provider. Remove it only as told by your child’s health care provider.
• Loosen the splint, brace, or boot if your child’s toes tingle, become numb, or turn cold and blue.
• Keep the splint, brace, or boot clean.
• If the splint, brace, or boot is not waterproof:
  • Do notlet it get wet.
  • Cover it with a watertight covering when your child takes a bath or a shower

If your child has a cast:

• Do notallow your child to stick anything inside the cast to scratch the skin. Doing that increases your child’s risk of infection.
• Check the skin around the cast every day. Tell your child’s health care provider about any concerns.
• You may put lotion on dry skin around the edges of the cast. Do notput lotion on the skin underneath the cast.
• Keep the cast clean.
• If the cast is not waterproof:
  • Do notlet it get wet.
  • Cover it with a watertight covering when your child takes a bath or a shower.

Managing pain, stiffness, and swelling

• If directed, put ice on the injured area:
  • If your child has a removable splint, brace, or boot, remove it as told by your child’s health care provider.
  • Put ice in a plastic bag.
  • Place a towel between your child’s skin and the bag or between your child’s cast and the bag.
  • Leave the ice on for 20 minutes, 2–3 times a day.
• Have your child gently move his or her toes often to avoid stiffness and to lessen swelling.
• Have your child raise (elevate) the injured area above the level of his or her heart while he or she is sitting or lying down.

General instructions

• Do notallow your child to use the injured limb to support his or her body weight until his or her health care provider says that it is okay. Have your child use crutches as told by the health care provider.
• Have your child do exercises as told by his or her health care provider.
• Do notallow your child to put pressure on any part of the cast or splint until it is fully hardened. This may take several hours.
• Give over-the-counter and prescription medicines only as told by your child’s health care provider.
• If your child is of driving age, ask his or her health care provider when it is safe to drive if your child has a cast, splint, brace, or boot.
• Keep all follow-up visits as told by your child’s health care provider. This is important.

Contact a health care provider if:

• Your child’s pain does not get better with rest or medicine.
• Your child develops more swelling.

Get help right away if:

• Your child’s skin or nails below the injury turn blue or grey or feel cold, or your child complains of numbness.
• Your child develops severe pain in the leg or foot.

Summary

• A fibular fracture is a break in the smaller of the two lower leg bones.
• Treatment depends on the severity of the fracture. A boot, cast, brace, or splint is used to protect the leg and promote healing. In severe cases, surgery may be needed.
• Icing, elevation, and pain medicine will help manage the pain and swelling. Follow directions as told by your health care provider.

Fibular Fracture Rehab

Ask your health care provider which exercises are safe for you. Do exercises exactly as told by your health care provider and adjust them as directed. It is normal to feel mild stretching, pulling, tightness, or discomfort as you do these exercises, but you should stop right away if you feel sudden pain or your pain gets worse.  Do notbegin these exercises until told by your health care provider.

Stretching and range of motion exercises

These exercises warm up your muscles and joints and improve the movement and flexibility of your lower leg. These exercises also help to relieve pain, numbness, and tingling.

Exercise A: Calf stretch, seated

1. Sit with your left / right leg extended.
2. Hold onto both ends of a belt or towel and loop it around the ball of your left / right foot. The ball of your foot is on the walking surface, right under your toes.
3. Keep your left / right ankle and foot relaxed and keep your knee straight while you use the belt or towel to pull your foot and ankle toward you. You should feel a gentle stretch behind your calf or knee.
4. Hold this position for __________ seconds.

Repeat __________ times. Complete this exercise __________ times a day.

Exercise B: Ankle alphabet

1. Sit with your left / right leg supported at the lower leg.
   • Do notrest your foot on anything.
   • Make sure your foot has room to move freely.
2. Think of your left / right foot as a paintbrush, and move your foot to trace each letter of the alphabet in the air. Keep your hip and knee still while you trace. Make the letters as large as you can without feeling discomfort.
3. Trace every letter from A to Z.

Repeat __________ times. Complete this exercise __________ times a day.

Exercise C: Passive ankle dorsiflexion

1. Remove your shoes and sit on a chair that is placed on a non-carpeted surface.
2. Place your left / right foot on the floor, directly under your knee. Extend your other leg for support.
3. Keeping your heel down, slide your left / right foot back toward the chair until you feel a stretch at your ankle or calf. If you do not feel a stretch, slide your buttocks forward to the edge of the chair while still keeping your heel down.
4. Hold this stretch for __________ seconds.

Repeat __________ times. Complete this exercise __________ times a day.

Strengthening exercises

These exercises build strength and endurance in your lower leg. Endurance is the ability to use your muscles for a long time, even after they get tired.

Exercise D: Dorsiflexion

1. Secure a rubber exercise band or tubing to a fixed object, such as a table or pole.
2. Secure the other end of the band around your left / right foot.
3. Sit on the floor, facing the fixed object. The band should be slightly tense when your foot is relaxed.
4. Slowly use your ankle muscles to pull your foot toward you.
5. Hold this position for __________ seconds.
6. Slowly release the tension in the band and return your foot to the starting position.

Repeat __________ times. Complete this exercise __________ times a day.

Exercise E: Plantar flexion

1. Sit with your left / right leg extended.
2. Loop a rubber exercise band or tubing around the ball of your left / right foot. The ball of your foot is on the walking surface, right under your toes.
3. Hold onto both ends of the band or tubing.
4. Slowly push your foot and toes away from you, pointing them downward.
5. Hold this position for __________ seconds.
6. Control the tension in the band as you slowly return to the starting position.

Repeat __________ times. Complete this exercise __________ times a day.

Exercise F: Ankle eversion with band

1. Secure one end of a rubber exercise band or tubing to a fixed object, such as a table leg or a pole, that will stay still when the band is pulled.
2. Loop the other end of the band around the middle of your left / right foot.
3. Sit on the floor, facing the fixed object. The band should be slightly tense when your foot is relaxed.
4. Make fists with your hands and put them between your knees. This will focus your strengthening at your ankle.
5. Leading with your little toe, slowly push your banded foot outward, away from your body. Make sure the band is positioned to resist the entire motion. Do notmove your heel.
6. Hold this position for __________ seconds.
7. Control the tension in the band as you slowly return to the starting position.

Repeat __________ times. Complete this exercise __________ times a day.

Exercise G: Ankle inversion with band

1. Secure one end of a rubber exercise band or tubing to a fixed object, such as a table leg or a pole, that will stay still when the band is pulled.
2. Loop the other end of the band around your left / right foot, near your toes.
3. Sit on the floor, facing the fixed object. The band should be slightly tense when your foot is relaxed.
4. Make fists with your hands and put them between your knees. This will focus your strengthening at your ankle.
5. Leading with your big toe, slowly pull your banded foot inward, toward your other leg. Make sure the band is positioned to resist the entire motion. Do notmove your heel.
6. Hold this position for __________ seconds.
7. Control the tension in the band as you slowly return to the starting position.

Repeat __________ times. Complete this exercise __________ times a day.