• Fibula fracture can occur during an inversion (inwards) ankle sprain
• It causes pain and swelling on the lateral (outside) aspect of the ankle
• Once identified, crutches and a camwalker boot are required for 1-2 weeks and 4-6 weeks respectively

TIPS

• Fibula fractures look like a simple ankle sprain when they happen. They have the same mechanism, same symptoms and same appearance as a ligament sprain
• A plain x-ray is usually sufficient to confirm a fibula fracture
• The Ottawa ankle rules are a great tool for anyone to identify the likelihood of a fracture after an ankle sprain

MYTHS

• You can still walk with a fibula fracture! It’s a non-weight bearing bone, so you can still put weight through it (although it will be painful). Don’t rule this injury out based on the ability to load it
• The amount of pain and swelling is often the same as a ligament sprain. The two injuries behave the same until around the 4th day when a fracture will continue to ache, even at rest
• Not every fibula fracture needs surgery. Fractures that are displaced (shifted) are more likely to require surgery to realign the fracture

WHAT ELSE COULD IT BE?

• The most common injury with very similar presentation to a fibula fracture is a Lateral ankle sprain
• If the pain came on gradually, it could be a Peroneal tendinopathy
• If the pain is more central than lateral, it could be a Syndesmosis injury
• If there is no tenderness to push on the posterior (back) of the fibula bone, it could be a Bone oedema/bruise