Young athletes, especially those involved in contact sports, and those individuals involved in motor vehicle accidents and pedestrian versus motor vehicle accidents, are likely at the highest risk. While tibia fractures are most common in young males and elderly females, it is likely that most isolated fibula fractures are in the younger population, based on the injury responsible for these fractures. EpidemiologyĪs stated earlier, isolated fractures of the fibula are quite rare, and not much literature exists on the frequency of their occurrence. Gunshot wounds are another mechanism from which an isolated fibula fracture can be sustained. They are typically the result of a direct injury to the leg, usually a fall or direct blow or blunt trauma like a sports injury or motor vehicle accident. EtiologyĪ truly isolated fracture of the fibula, one that has no other associated ligamentous or other bony injuries, are quite rare. The deep peroneal nerve is responsible for sensation over the first dorsal webspace. A common result of damage to the deep peroneal nerve is drop foot, in which there is a loss of the capacity to dorsiflex the foot. The deep peroneal nerve innervates the musculature of the anterior compartment and is responsible for the dorsiflexion of the foot and toes. The superficial peroneal nerve also gives sensation to the dorsum of the foot. Damage to this nerve may result in deficits in those movements. The superficial peroneal nerve innervates the musculature of the lateral compartment and is responsible for eversion and, to a much milder degree, plantarflexion of the foot. The triangular shape of the fibula is dictated by the insertion points of the muscles on the shaft. The fibular shaft is an origin for multiple muscles of the leg, including muscles of the anterior compartment (extensor digitorum longus, extensor hallucis longus, peroneus tertius), the lateral compartment (peroneus longus, peroneus brevis), the superficial posterior compartment (soleus), and the deep posterior compartment (tibialis posterior and flexor hallucis longus). Both the posterior and medial malleolus are part of the distal end of the tibia. This article focuses on the shaft of the fibula, which can be located between the neck of the fibula, the narrowed portion just distal to the fibular head, and the lateral malleolus, which in concert with the posterior and medial malleoli, form the ankle joint. There are several distinct portions of the fibula in terms of structure, including the head, neck, shaft, and the distal end termed the lateral malleolus. There is very limited mobility between this syndesmosis. The fibula and tibia connect via an interosseous membrane, which attaches to a ridge on the medial surface of the fibula. ![]() At its most proximal part, it is at the knee just posterior to the proximal tibia, running distally on the lateral side of the leg where it becomes the lateral malleolus at the level of the ankle. Located posterolaterally to the tibia, it is much smaller and thinner. The fibula is one of the two long bones in the leg, and, in contrast to the tibia, is a non-weight bearing bone in terms of the shaft. ![]() The following article will focus on fractures of the fibula that are proximal to the ankle joint and the treatment of such fractures. One reason for this may be the treatment for the vast majority of isolated fibula shaft fractures is non-operative - this contrasts with the treatment of lateral malleolus fractures, which, although it is part of the fibula, technically, are categorized as ankle fractures and, therefore, have different treatment principles. Explain the importance of collaboration and communication among the interprofessional team to ensure appropriate treatment of patients who present with an isolated fracture of the fibula shaft.Īlthough tibia and fibula shaft fractures are amongst the most common long bone fractures, there is little literature citing the incidence of isolated fibula shaft fractures.Review the treatment options for an isolated fibula shaft fracture.Outline the proper evaluation of a patient who has a fibula shaft fracture.Describe the typical mechanism of isolated fibula fractures.This activity reviews the evaluation and treatment of isolated fibula shaft fractures by an interprofessional team. Fortunately, the vast majority of isolated fibula fractures are treated nonoperatively. Isolated fibula fractures are quite rare, much less common than fibula fractures with associated ligamentous involvement and/or tibia fractures.
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