Fibula fracture - how to tell if it's broken

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

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

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

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