Associated symptoms

Isolated fibula fracture is rare. In most cases, a distal fibula fracture occurs, in which the upper ankle joint or even the head of the fibula is also affected. In addition to these injuries, the syndesmosis ligament can also be injured as part of a fibula fracture.

The syndesmosis ligament is a tight, collagenous or elastic ligament structure or ligament connection, which is located in the distal area, between the tibia and the fibula. The syndesmosis ligament in the area of the tibia and fibula is also known as syndesmosis tibiofibularis. The syndesmosis ligament keeps the distance between the two bones of the lower leg, i.e. the distance between the tibia and the fibula, constant.

The syndesmosis band also serves to stabilize the ankle fork (malleolar fork). Injuries to the syndesmosis ligament always result in changes to the upper ankle joint. These injuries must always be treated in order to preserve and protect the upper ankle joint from arthrosis.

Pain

In a closed fibula fracture, pain in the fibula, as well as pain in the distal fibula area, are the predominant symptoms. At the same time, the injured area may be swollen due to injury to surrounding structures (vessels, tissue or nerves). Since the syndesmosis ligament is usually also injured in fibula fractures, pain can develop over the upper ankle joint, especially in the front part of the upper ankle joint, when the syndesmosis ligament is damaged or injured.

Diagnosis

The diagnosis of a fibula fracture or a distal fibula fracture involving the upper ankle joint is carried out by means of X-ray diagnostics, whereby an X-ray image is taken in 2 planes to provide a complete picture of the joint. Since fibula fractures usually also involve an injury to the syndesmosis ligament, an MRI examination is necessary for clarification. X-ray a. p. : fibula fracture with slight displacement

Treatment

In general, however, it can be said that the treatment of fibula fracture depends on the type of fracture. The treatment options for fibula fractures are divided into conservative treatment and surgical treatment.If an injury in the area of the lower leg is suspected, the lower leg is first fitted with an orthosis or splint for immobilization. It is also advisable to elevate the injured lower extremity.

In order to plan further treatment, a precise diagnosis must be made as to whether it is a smooth, isolated fracture of the fibula or whether other structures, such as the upper ankle joint or the syndesmosis ligament, have been affected by the injury. If it is a smooth, non-displaced fracture of the fibula, it can be treated with a walking cast. However, if several structures are affected, they may need to be treated with plates, screws or wire cerclages.

A fracture of the fibula shaft rarely requires surgical treatment. Cerclages are metal wire loops or wire bands used in trauma surgery for osteosynthesis of fractured bone structures. With the help of cerclages, the fractured bone structures are wrapped around and thus reassembled in the form of an osteosynthesis (surgical connection or joining of two bone fragments). In most cases, a fibula head fracture is caused by a direct impact of the fibula head (e.g. when playing soccer). These fractures can possibly lead to complications, since an important lower leg nerve (nervus peroneus/fibularis) runs directly behind the head of the fibula, which can be damaged in these fractures.