Proximal fibula fractures (North Mid)

What is a proximal fibula fractures?

This is a break to the bone on the outside of your leg below the knee.

Healing

It will take six weeks for the fracture to heal; however, in some cases, it may take longer especially Smoking will slow down your healing. We would advise that you stop smoking while your fracture heals. Talk to your GP for more information.

Pain and swelling

Your ankle may be swollen and painful. Swelling is often worse at the end of the day. It is normal to have mild pain and swelling for three to six months after your injury. Taking pain medication, elevating your ankle and using ice or cold packs will help. More information is further down this page.

Wearing your boot

The boot protects your ankle and will make you more comfortable. Wear the boot when you are standing and walking for the first two weeks. You can take it off at night and at rest. Please inform us if you are diabetic; you may need a special boot. You are allowed to put weight on your foot. You may find it easier to use crutches in the early stages.

Exercise and activity

It is important to start exercises as soon as possible. Instructions are further down this page.

Follow up

Routine follow up appointments are not normally needed after this injury. If you still have significant pain or swelling after 6 weeks, please contact the virtual fracture clinic.

Caring for your injury

Remember to wear your boot whenever standing and walking for the first two weeks. You can remove the boot when resting and at night. Wear a long sock in your boot.

Remove your boot to wash, dress and do your exercises. 

Try to stop using the boot and crutches after two weeks. Practice walking without you boot and crutches around your home first. Build up to longer walks outside. You should have stopped using them by six weeks after your injury, at the latest

Using a cold pack will help with your pain and swelling. You can use an ice pack or bag of frozen peas wrapped in a damp towel. Put this on your ankle for 15 minutes every few hours. Make sure the ice isn’t in direct contact with your skin.

Try to rest your ankle, especially in the first 24-72 hours. Raise your ankle on a stool or cushions so that it is above the level of your hip. This will help to reduce your swelling.

Exercises

Early movement of the ankle and foot is important to promote circulation and reduce the risk of developing a Deep Vein Thrombosis (blood clot). Do these exercises three to four times a day. Start straight away, you do not need to push into pain.

 Ankle exercises

Rest with your leg supported. Point your foot up and down. Repeat this 10 times.

Point your toes down as far as they go, place your other foot on top and apply some pressure. This will stretch the top of your foot. Hold for 30 seconds.

Static quadriceps exercise

Rest with your leg supported and straight. Gently tense the muscles in your thigh and try to straighten your knee further. Hold for five seconds and repeat seven to 10 times.

Inner range quads exercise

Place a rolled up towel or small pillow under your injured knee.

Tense your thigh muscle and try to straighten your knee. Keep the back of your knee in contact with the towel/pillow.

Repeat 10 times. If you can, try to hold your knee straight for five seconds.

Knee flexion and extension 

Sit or lie with your legs out stretched. 

Bend and straighten your injured leg. Go as far as you feel comfortable.

Repeat seven to 10 times.

Seated knee flexion and extension

When you can do the first knee bending exercise easily, you can progress to this exercise.

Sit on a chair or on the edge of the bed. Bend and straighten your knee, lifting your heel off the floor.

Repeat this 10 times.

If you can, try holding your knee straight for five seconds.

I am struggling with my boot. What do I do? 

The boot has a thicker sole; this can make you feel uneven. Make sure you wear a supportive shoe or trainer on your uninjured foot. This will reduce stress on other joints. If you need more advice, contact the Virtual Fracture Clinic.

Watch this NHS video on fitting your boot

I am diabetic, does this change things?

If you are diabetic please contact us to discuss your boot. This is particularly important if you have problems with your skin or sensation. We may provide you with a specialist diabetic boot.

Driving

You can return to driving when:

• You are no longer using your boot, 
• You can walk comfortably and 
• You can perform an emergency stop pain free. 

Always test your ability to drive in a safe environment first.

Fitness for work statement

You can get a fitness for work statement from your GP or the doctor at your Fracture Clinic appointment.

What do I do with my boot and crutches when I no longer need them? 

We are not able to use boots again. These should not be returned to the hospital. Crutches can be returned to the fracture clinic or emergency department (A&E).