Fibular Shaft Fracture

MANUAL MINORS

A fibular shaft fracture is an injury affecting the middle portion of the fibula, the thinner, lateral bone of the leg. While the fibula does not bear weight like the tibia, it plays an important role in stabilising the leg and ankle.Fibular shaft fractures can occur in isolation or in association with tibial and ankle injuries, and are generally caused by direct trauma, twisting injuries, or falls.

Diagnosis

Diagnosis is based on clinical evaluation and imaging studies. Patients typically present with localised pain on the lateral side of the leg, swelling, and difficulty walking or bearing weight. In some isolated fibular fractures, pain may be less intense compared to tibial fractures.

Leg X-rays are essential to confirm the fracture and assess any displacement. In complex fractures or suspected additional ankle damage, magnetic resonance imaging (MRI) or computed tomography (CT) may be performed.

Differential Diagnosis

Condition	Key Differentiation
Tibial Shaft Fracture	Severe pain and visible deformity, usually affecting the ability to bear weight
Ankle Sprain	Pain and swelling in the ankle joint, no fracture visible on X-ray
Bone Contusion	Localised pain following a blow, no fractures visible on X-ray
Lateral Malleolus Fracture	Pain around the ankle, detected on X-ray, more common after severe twisting injuries
Lateral Collateral Ligament Injury	Pain and a feeling of instability, no bony deformity or visible fracture

Emergency Management

In the emergency department, initial management of fibular shaft fractures includes immobilisation with a splint or elastic bandage to limit movement and alleviate pain. Analgesics and non-steroidal anti-inflammatory drugs (NSAIDs) are administered for pain control.

It is important to assess ankle stability and check the integrity of surrounding vessels and nerves. If there is suspicion of an associated tibial fracture or ankle damage, the patient should be referred for further orthopaedic evaluation.

Definitive Treatment

Definitive treatment for fibular shaft fractures depends on the type and stability of the fracture. Isolated, non-displaced, and stable fractures are usually managed conservatively with immobilisation using a cast or walking boot for 4 to 6 weeks.

In displaced or unstable fractures, especially if the ankle is involved, surgical intervention may be required for reduction and internal fixation with plates and screws. Post-immobilisation rehabilitation is essential to restore function and prevent complications.