Fibula Fractures: Healing Concerns After a Leg Injury

Both bones of the lower leg are fractured?

I had a car accident in mid-February this year, resulting in a complete fracture of the tibia and fibula in my left lower leg (non-open fracture).
I underwent surgery to insert a steel rod for stabilization of the tibia, but the fibula was not treated.
During a follow-up appointment at the end of March, an X-ray revealed that the fibula is still in a "displaced" state.
I can still feel the bone moving with light pressure.
I consulted with my doctor, who mentioned that typically, the smaller bone is not treated and did not discuss any potential future treatment options.

Given this "displacement," is it possible for the fibula to heal on its own? Could it be that the ends of the fracture heal together, but the bone itself does not unite? Will there be a clicking sound when walking in the future? Will this affect my ability to walk or engage in physical activities? Thank you for taking the time to address my concerns; I greatly appreciate it.

Yīzhí gǎndào bù'ān de Āhuā, 30~39 year old female. Ask Date: 2006/04/14

Dr. Shi Guozheng reply Orthopedics

In the case of simultaneous diaphyseal fractures of the tibia and fibula, it is sufficient to treat only the tibia, as the fibula will heal on its own.
This is unlikely to have any significant long-term effects.

Reply Date: 2006/04/14

More Info

Fibula fractures can be a significant concern, especially when they occur alongside tibial fractures, as in your case. The fibula, while not bearing as much weight as the tibia, plays an essential role in stabilizing the ankle and supporting the muscles of the lower leg. Understanding the implications of a fibula fracture, particularly one that is misaligned or "displaced," is crucial for ensuring proper healing and function.

In your situation, where the fibula was not surgically treated and remains in a displaced state, there are several factors to consider regarding healing and future mobility. Generally, fibula fractures can heal without surgical intervention, especially if they are stable and not significantly displaced. However, the alignment of the bone is critical for optimal healing. If the fibula is misaligned, it may lead to complications, such as improper healing or malunion, where the bone heals in an incorrect position.

1. Self-Healing Potential: The fibula has a good potential for self-healing, especially in younger individuals with good blood supply. However, if the fracture is significantly displaced, it may not heal correctly. The body can sometimes compensate for a misaligned fibula, but this can lead to long-term issues, such as pain or instability in the ankle.

2. Concerns About Non-Union: If the two ends of the fibula do not heal together properly, this could lead to a condition known as non-union, where the bone fails to heal. This could result in chronic pain, instability, and potentially a "clicking" or "popping" sensation when walking, as the bones may not be properly aligned.

3. Impact on Mobility: While a misaligned fibula may not immediately impact your ability to walk, it can lead to long-term complications. If the fibula does not heal correctly, you may experience issues with balance, stability, and even pain during activities. This could affect your ability to engage in sports or other physical activities.

4. Future Considerations: It is essential to monitor the healing process closely. If you continue to feel movement at the fracture site or experience pain, it would be prudent to follow up with your orthopedic surgeon. They may recommend further imaging, such as an X-ray or MRI, to assess the healing status of the fibula. If there is significant displacement or if you are experiencing ongoing symptoms, surgical intervention may be necessary to realign the bone.

5. Rehabilitation: Regardless of whether the fibula heals on its own or requires surgical intervention, rehabilitation will be crucial. Physical therapy can help strengthen the muscles around the ankle and improve stability, which is vital for preventing future injuries.

6. Long-Term Outlook: Many individuals with fibula fractures can return to their previous level of activity, especially if the fracture heals well. However, if there are complications, such as malunion or non-union, this may require additional treatment and could affect your long-term mobility.

In summary, while the fibula has the potential to heal on its own, the current misalignment raises concerns about the quality of healing. It is essential to maintain open communication with your healthcare provider and advocate for further evaluation if you have ongoing concerns. Regular follow-ups and possibly imaging studies will help ensure that any issues are addressed promptly, allowing for the best possible recovery and return to activity.

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