Fibular fractures, particularly those involving the ankle and the shaft just proximal, are common. They often result from minor trauma. Initial management is often provided by primary care and emergency clinicians, who must therefore be familiar with these injuries.
The diagnosis and management of fibular fractures is discussed here. Ankle fractures and sprains, stress fractures of the fibula, and fibula fractures in children are reviewed separately. (See "Overview of ankle fractures in adults" and "Ankle sprain" and "Stress fractures of the tibia and fibula" and "Tibial and fibular shaft fractures in children" and "Ankle fractures in children".)
EPIDEMIOLOGY AND RISK FACTORS
Fibular fractures in adults are typically due to trauma. Isolated fibular fractures comprise the majority of ankle fractures in older women, occurring in approximately 1 to 2 of every 1000 white women each year . Fibular fractures may also occur as the result of repetitive loading and in this case they are referred to as stress fractures.
In older adults, the key risk factor for fractures of the fibular or tibial shaft appears to be bone mass. Factors that reduce bone mass had greater impact than overall health status or other risk factors for falling. Cigarette smoking is another important risk factor for fibular fractures .
Athletes engaged in sports that involve cutting, particularly those associated with contact or collision, have a higher incidence of fibular fractures . Typical examples include American football, soccer, and rugby. Participants in downhill winter sports have relatively high rates of fibular fractures. These are more common in snowboarding than skiing, and fracture patterns are different for each. Skiers often fracture the proximal third of the tibia and also the fibula, whereas snowboarders are more likely to sustain isolated fractures of the distal third of the fibula .