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
Ottawa ankle rules
Ottawa ankle rules. From


  • 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
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