One of our patients (we’ll call her Anita) came to see us a few weeks ago with a very sore ankle. She had been walking her dog that morning. The dog was running and playing, and her big Rhodesian Ridgeback slammed into Anita’s leg, just above the foot. She limped home, supported by her friend, and called us immediately.
An x-ray quickly revealed that Anita had a fractured fibula. We treated her with a nonsteroidal anti-inflammatory drug for pain, fitted her with a boot to protect the ankle from movement, and told her she’d have to find someone to walk her dog for a month or two.
No doubt this injury is painful, as it reminds the patient with each step that she has a fractured bone. However, the prognosis is good and recovery is usually fairly swift.
Patients can sustain a direct hit to the fibula, as happened with Anita. This sometimes occurs in sports – for instance, if you are hit with a lacrosse stick or a golf club. The fibula can also crack because of repeated stress, especially in older patients whose bones are brittle or thinned by osteoporosis. More rarely, the fibula may fracture when the leg is twisted violently.
The fibula is the smaller of two bones in the lower leg. (The other is the tibia.) If treated, fibular fractures usually heal within four to six weeks. Complications are rare, but possible, including:
- Failure of the bone to heal
- Bone that heals in a poor position
- Shortening of the injured bone
- Bone growth that is hampered in children
- A longer recovery time if the patient tries to resume his or her dog-walking before the injury is healed.
In some cases a fibular fractures might require surgery. With or without surgery, the leg is usually restrained with a brace or a walking boot. Crutches are advised. If there is persistent swelling above or below the fracture, call one of our clinics in Dallas, DeSoto or Sunnyvale. Excess swelling could result in damage to muscles or nerves.
A fractured fibula needs time to heal
While we don’t want you walking on the ankle during the healing period, stretching exercises will be prescribed to help restore flexibility. Hold a stretch for at least 30 seconds, but don’t try to endure pain. Stretching should not be painful, and should produce a sensation of lengthening or tension release in the ankle area.
Some examples of stretching exercises include dorsi-plantar flexion, when you grasp the top of your foot and pull it upward. You can also sit with your leg extended, and loop a belt or a towel around the ball of your foot and then pull it towards you.
Your physical therapist can show you stretching exercises that won’t aggravate the fractured bone. And this website from the American Orthopaedic Foot & Ankle Society has photos and descriptions of rehab exercises
For general condition, think of exercises that don’t involve standing or running. Swimming is always a good cardiovascular workout, with no impact on the leg. Yoga and floor exercises are other possibilities.
The doctor will want to see you regularly until your fibula is completely healed, to make sure there are no complications and that the bone is knitting as it should. In the meantime, the patient is asked to be patient and give the bone time to heal.
We may schedule additional x-rays to make sure the bone is healing properly. Arthritis can result if the bone does not align itself as it should. If a child suffers a fractured ankle, we will want to check it regularly for up to two years, to make sure the fracture doesn’t result in uneven leg length or another type of deformity.