Ankle Fractures (Fibula) Causes, Symptoms & Treatment

The fibula bone is a long thin bone on the outside of the leg that extends from the knee to the ankle. Most of your weight is carried by the larger bone of your leg called the tibia (shin bone).

At the ankle joint, the fibula is often called the lateral malleolus and when the fibula is broken at the ankle it may be called a lateral malleolus fracture. The fibula can be broken or fractured anywhere along its course from the outside of the knee to the ankle.

Pain below the fibula is often associated with an ankle sprain while pain on the bone itself can be associated with a fracture. When you have a lateral malleolus fracture, it is likely very painful to bear weight and there is pain if you touch the bone itself on the outside of your ankle. Both ankle sprains and fibula fractures occur from a similar mechanism, frequently by your ankle rolling under you. You may hear a pop or crack. This is frequently associated with bruising and swelling of your ankle.

Ankle fractures are usually caused by twisting or rolling your ankle. Sometimes they happen due to an acute injury, such as from a fall or car accident, or simply following a mis-step. Occasionally, ankle stress fractures may develop over time, due to chronic overuse without adequate time for recovery, repair, and rebuilding.

Ankle fractures are most common in these sports:

• Running
• Basketball
• Soccer
• Football
• Tennis
• Skiing

A common symptom of an ankle fracture is pain. Pain is often immediate at the time of injury and can be severe. Common symptoms also include:

• Pain increases with activity and eases with rest
• Swelling and bruising around the ankle
• Tenderness to touch over the fibula (bone on the outside of your ankle)
• Inability to put weight on the ankle
• Deformity of the ankle

If you injure your ankle and are unable to put weight on your ankle or if you touch the bone and it is painful you should see a doctor and have x-rays as the inability to weight bear and tenderness to the touch are signs of a broken or fractured ankle

Ankle fractures can be mistaken for sprains, so it is important your injury is properly diagnosed. Your doctor will ask questions about your injury and symptoms and conduct a physical examination. This may include moving your foot in different directions to test your range of motion and stability, as well as examining how you walk. Your doctor may also order  other imaging tests to assess the extent of your injury.

Treatment of ankle fractures will depend on the severity of the fracture. Stable fractures are typically treated non-surgically. Treatment usually involves rest and keeping weight off the ankle to allow the fracture to heal. Conservative treatments also include:

• Ice
• Elevation of the leg
• Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen and naproxen, to relieve pain
• A splint, cast, walking boot, or sturdy brace to provide stability to the ankle
• Physical therapy exercises

After you have recovered and your doctor says it is okay

Try these exercises to help address your condition:

Below is a PDF of the Exercise ProgramAnkle Fracture

If the ankle fracture is unstable or out of place, surgery may be the right treatment option for you. In these cases, surgery can help the ankle regain its proper function and prevent arthritis from developing. During the procedure, the orthopedic surgeon realigns the broken bones and holds them together with pins/screws and plates. The surgeons may use arthroscopic surgery, a minimally invasive procedure, to operate on your ankle.

Recovery time from an ankle fracture can vary widely depending on the extent of the injury. Typically, after treatment with a cast or surgery, it takes at least six weeks for broken bones and ligaments to heal enough to start weight bearing activities with a walking boot. Physical therapy will play an important role in an athlete’s recovery and return to play.