Fibula Fracture: How you can Heal


Inform many associates that you’ve a fibula fracture, they usually’ll typically reply, “It’s not an issue. It’s not a weight-bearing bone.” Nonetheless, your good friend doesn’t have the fracture. Belief us. Making an attempt to heal from a fracture on the fibula might be painful, lengthy, and tough. Simply because it doesn’t bear all of the leg’s weight, it does bear some. The attainable ache and irritation could cause you to remain off your toes and gradual your therapeutic.

Runner laying on the ground with pain from a fibula fracture.
A fibula fracture might be painful and gradual to heal.

What’s the Fibula Bone?

The fibula is a slender, lengthy bone outdoors the decrease legs. It runs from beneath the knee and all the way down to the ankle joint. Subsequent to the fibula bone is the tibia bone, the thicker bone of the 2. Collectively, they type the bottom of the knee (known as the tibial plateau).

The tibia and fibula are related by ligaments beneath the knee and on the ankle. There’s additionally a delicate tissue between the 2 bones, known as the interosseous membrane, which runs the size of the 2 bones. The interosseous membrane binds the 2 bones collectively to maintain them secure. The ligaments and the interosseous membrane have a bit of flexibility in them, permitting the ankle joint and the 2 bones to maneuver throughout strolling and movement of the ankle. The fibula can bend barely, and it might probably additionally rotate inside its ligament. It will probably additionally slide up and down throughout ankle movement, inward and outward.

The fibula bone performs a minor function in bearing the physique’s weight as we stroll. The tibia bears roughly 80% of the physique’s weight. The fibula bone bears solely 15 to twenty% of the physique’s weight. Furthermore, it transfers forces because the ankle hits the bottom throughout strolling. The mechanism of transferring floor response forces happens as a result of muscle attachments on the higher a part of the fibula bone beneath the knee. The interosseous membrane additionally helps switch rotational forces from the ankle to the knee. Some nerve tissues, veins, and arteries cross behind the fibula close to the knee. The fibula is a web site of 5 muscle attachments.

How you can Get a Fibula Fracture

Fibula bone fractures are a standard harm within the emergency room. Usually, a fracture happens from:

  • A direct blow to the skin of the leg;
  • From twisting the decrease leg awkwardly and
  • From a extreme ankle sprain.

The harm is frequent in athletes who interact involved sports activities equivalent to soccer, soccer, basketball, rugby, and Lacrosse. Downhill skiers, snowboarders, and skiers even have excessive charges of fibula bone fractures. In aged individuals, slips and falls typically trigger fibula bone fractures.  It may additionally happen when bone mass depletes within the aged. Furthermore, surprisingly, smoking is a vital threat issue for fibula bone fracture.

Recovering from a Fibula Bone Fracture Takes Time

All bones heal in three phases: irritation, restore, and transforming.

The Irritation Part Takes about 5 Days

Because the bone fractures, it bleeds. It’s that bleeding that causes irritation. The blood or hematoma (blood clot) enters the area between the 2 fractured fragments to provoke therapeutic or the restore course of. 

The Restore Part Takes About 40 Days

A delicate callus is shaped throughout the fractured web site through the restore section. The delicate callus fills the bone, growing into a tough, inflexible callus.

The Transforming Part Takes about 100 Days

After the arduous, inflexible callus is shaped, the reworking section begins.  On this section, the bone remodels itself into its unique dimension and regains its energy properties. This section takes 100 days.

Issues Can Make Therapeutic a Fibula Fracture Tough

The common time for bone therapeutic is 8 to 10 weeks, and the whole therapeutic time is 12 to 16 weeks. The pure therapeutic time ought to be allowed to take its standard course. In the event you select to be energetic, you possibly can trigger plenty of issues:

  • Interference with the pure therapeutic time, equivalent to not following the weight-bearing standing from the doctor, can displace the hematoma, and the bone can’t heal.
  • An excessive amount of movement early on the fractured web site prevents the arduous, inflexible callus from forming, leading to non-union of the fracture fragments. The fractured web site can then develop into unstable. 
  • Poor blood provide to the fractured web site additionally prevents the formation of the arduous, inflexible callus. That’s the reason people who smoke have a tough time therapeutic. Smoking decreases blood provide to the fracture web site.

The place Does the Fibula Bone Fracture Happen?

There are completely different areas the place the fibula bone can fracture. For instance, the fracture can happen on the knee joint, above the ankle, within the shaft of the fibula bone, and on the ankle joint.

The tip of the fibula bone on the ankle joint may also separate, known as an avulsion fracture. This occurs from a extreme ankle sprain. The situation of the fracture dictates restrictions positioned on a affected person. On an remoted fracture, equivalent to a fracture within the shaft of the fibula bone, that fracture is uncomplicated, and confidence for full therapeutic is excessive.

Nonetheless, fractures on the knee and ankle take longer to heal, and restriction and immobilization are crucial to therapeutic. A fracture on the knee is related to problems because of the muscle tissue, ligaments, and interosseous membrane attachments in that location.

Most physicians’ concern at this location is the encircling nerves, veins, and arteries. Problems can develop into extra of a priority when the fracture is above or on the ankle joint. The priority is tearing the ligaments that join the tibia bone and the fibula bone that type the ankle joint.

The restriction and immobilization are extreme as a result of instability. One should take note of right here the time it takes for bone and ligaments to heal earlier than placing weight on it, as each tissues heal at completely different instances.

Woman who had a fibula fracture.

How you can Deal with a Fibula Fracture

Docs heal a fibula fracture with immobilization. That is performed both with a CAM walker boot or with surgically put in screws and plates (relying on the gap between the fractured fragments). The bigger the gap between the fragments, the extra immobilization is required as a result of therapeutic depends upon the hematoma becoming the area between the fragments.

The hematoma initiates the therapeutic course of: rising from a delicate callus to a tough, inflexible callus to reworking. Immobilization with a boot or surgical procedure brings the fractured section nearer so the blood clot can match the area to provoke therapeutic.

Extreme or early weight bearing can displace the blood clot and interrupt therapeutic. Because of this physicians suggest non-weight bearing for the primary 4 to six weeks.

Keep in mind that it takes 4 to 6 weeks for the arduous, inflexible callus to type and for reworking to start. At the moment, weight-bearing turns into important in serving to the bone transform to its unique dimension.

Furthermore, management or gradual weight bearing is paramount. Weight-bearing on the therapeutic leg progresses from non-weight bearing to the touch weight bearing, partial weight bearing to weight bearing as tolerated, and at last to full weight bearing. Fibula bone fractures heal sooner than weight-bearing bones, such because the tibia. Problems can come up from weight bearing and early movement on the fracture web site.

Immobilizing the Leg is Key to Therapeutic

Patient with a CAM walking boot.
The CAM Strolling Boot Reduces Fibula Stress

Immobilization is paramount within the therapeutic course of. It retains the gap between the fracture fragments shut to permit therapeutic to happen, as defined earlier. It compresses the fractured fragments to assist and maintain the bone secure. Compression additionally takes stress off the surgical stitches.

A number of varieties of immobilization are used to deal with fibula fracture, equivalent to a CAM strolling boot, which is available in non-inflatable, adjustable inflation, permits vary of movement, and a all-time low boot.

  • The CAM strolling boot wraps the foot, ankle, and decrease leg under the knee.
  • The non-inflated CAM walker gives primary assist to the fractured fragments.
  • The inflated CAM strolling boot is the place the bladder is inflated with air to extend stability and accommodate swelling within the leg.
  • The vary of movement boot is adjusted to permit a restricted vary of movement.
  • The all-time low boot permits pure rocking movement on the foot throughout strolling. Because the fractured leg heals, the CAM boot is changed by a plastic air stirrup-type brace or an ankle laced-up brace.

Keep in mind the R.I.C.E.

After immobilization, use the RICE precept to handle swelling and ache. “RICE” stands for:

  • Rest the injured/surgical leg,
  • Ice the injured leg,
  • Compression is utilized to the injured leg utilizing an ace wrap, and
  • Elevation of the injured leg above the guts to empty the swelling.

One key to success after a surgical process is to make use of compression and elevation to lower swelling. The sooner the swelling subsides, the sooner there may be restoration.

Don’t Put Weight on Your Leg

Non-weight bearing means no weight on the therapeutic leg. You possibly can scale back stress in your leg with a wheel walker, crutches, or a knee scooter. Something to scale back weight in your leg helps promote therapeutic.

What’s Contact Weight Bearing

Contact weight bearing is when the foot and toes are touching the ground. It offers the muscle tissue of the leg a break from holding the leg up. It additionally helps the leg to develop into accustomed to minimal weight bearing.

Partial Weight-Bearing 

Partial weight-bearing step by step permits the leg to carry extra weight – as much as 50% of your physique’s weight. Throughout this section, your physique weight is equally distributed on the therapeutic leg and the assistive system. Weight-bearing as tolerated is from 50% to 100% of the physique weight on the therapeutic leg. Lastly, full weight bearing is 100% of the physique weight on the therapeutic leg with no assistive system. Weight-bearing on the therapeutic leg progresses from non-weight bearing to the touch weight bearing, partial weight bearing to weight bearing as tolerated, and at last to full weight bearing.

A Remaining Phrase a few Fibula Fracture

A phrase on fibula bone stress fracture: It isn’t a real fracture. It’s known as a hairline fracture as a result of repetitive stress on the fibula bone. The fracture fragments usually are not separated. One can consider it as a crack within the bone. Throughout long-distance working, mountaineering, and so forth, the bone reacts to extreme stress, leading to a hairline fracture. Exercise will increase the ache, and relaxation decreases the ache. Eradicating the stress on the bone is the one technique to restoration.

Name STARS at (208) 367-3315 when you have any questions concerning fibula fracture.

Article Credit score: Raj Issuree, MPT


References:

  • McKibbin B. The biology of fracture therapeutic in lengthy bones. J Bone Joint Surg 1978; 60-B (2): 150-162
  • Perren SM, Rahn BA. Biomechanics of fracture therapeutic. Can J Surg 1980; 23(3): 228-32
  • Connolly JF, Maha H et al. Fracture therapeutic in weight-bearing and non-weight-bearing bones. J Trauma 1978; 18(11); 766-70

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