Fracture of the fibula bone: causes, treatment and rehabilitation after injury

Fracture of the fibula: svenciausios movement to injury

Compared to the tibia bone looks like a small relatively thin, slightly spirally twisted three-edged needle, «put in charge» to it from the outside.

But the word «small» does not mean unimportant, insignificant. Because without it, there would be formed no Shin (dahkota system, similar to the forearm) or the ankle joint.

Because, like the radial bone of the forearm, small tibia, utadas down, flat ledge to your head forms the outer ankle of the ankle joint.

But, unlike the forearm, mobility of the tibia relative to each other is severely restricted – pronation and supination are impossible. Because the methods of joining bones in these two similar systems are different, and this is crucial for understanding the mechanism of fracture of the fibula.

Anatomical subtext

The heads of both bones of the Shin (as above, so below) connected with nearly flat joints. Therefore, free sliding heads on each other here – there is PROPADIENE connection with their very dense prileganija to each other.

But at the same time as the proximal (top) and distal (bottom) of the head of the fibula are present articular surfaces and joint cavity in the form of a narrow slit-like spaces.

And the small bone is not firmly adherent to a large, and has a slight freedom of movement relative to it. For a special the strength of their connection is taut between them a strong fibrous membrane – the interosseous membrane.

It remains to add that in the formation of the knee joint, the upper head of the fibula is not involved, and on the inner surface of the lateral malleolus has articular surface for connection with the talus bone part of the ankle joint.

Which causes a fracture of the fibula

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According to statistics, most of the little fractures of the tibia occurs:

  • in the fall (in feet) height;
  • as a result of direct ramming strike on the outer half of the tibia (kick the bumper of a car);
  • from «svenciausios» movement in fixed-calf (as in leg while wearing ski).

To the question: why is this happening (why is the epiphysis of the bone is broken or it happens in the region of the necks), is responsible… sewing pin – coiled-spring wire with a padlock.

Pushing on the free end (imitation of ramming), rathmichael pin and the resulting model of fracture in the cervical area (upper or lower). The same thing happens when squeezing the pins along the longitudinal axis or twisting it – it unzips.

But, unlike metal its like, Shin bones are connected by a bonding and their interosseous membrane, then what happens to her? The answer is simple: under the effect of rapid application of significant force, it breaks (often in the lower part).

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A hammer blow on the chisel that cuts the same part shows a fracture in the middle part of the pineal gland, and – the divergence of the displacement of fragments of bone.

Cause of fracture does not have to be injury – it could be bone lesion osteomyelitis, sarcoma or «dilution» of its structure due to osteoporosis.

Fracture of the lateral malleolus occurs, one of the «scenarios». Either:

  • the foot must turn up in the outside (pronation) or the inner (varus) side (which often happens in the period of ice);
  • the ankle joint must be highly compressed-squeezed (for example, road trauma);
  • direct blow to the ankle with a heavy object (including falling);
  • there should be a rotation (forced rotation) of the foot to the inside or outside (sports, especially skiing injuries).

With displacement and without it

Having considered the mechanism of fracture on the wire-pin models, it remains only to enumerate possible types depending on the point of application of destructive force.

  • when ramming impact, the fracture can be transverse,
  • if you fall on your feet (or at direct hit) comminuted or fragmented (fragmentation into a large number of fragments),
  • when tucked (or locked) the foot of the spiral.

When the divergence of bone fragments, the injury is called a fracture with displacement, without differences by fracture of the fibula without displacement. The fracture is not to the full depth of the bone is a fracture.

A curious fact: the most frequent fracture of the lateral malleolus (at any height) also refers to the fracture of the fibula.

That will point to the injury?

As in fracture of any other bone, at fracture fibula bones as a result of injury appear the pain and dysfunction of the limb (the foot cannot occur without pain).

But the pain doesn’t always appear. In the elderly with low pain threshold at fracture as the result of sarcoma sensations can be mild.

The same thing happens when you damage the peroneal nerve – the outer surface is not only tibia but also foot «numb», loses sensitivity, and tearing of nerve foot back to bend it.

Sticking out of wound (or visible), bones speak volumes about an open fracture of the fibula.

To put and clarify the diagnosis of the first goal

Diagnosis is simple inspection and feelings of the injured area often enough (hematoma has nothing to say).

Inaccessible to palpation of the affected area due to a thick layer covering its muscles, it may not manifest itself by pain, an incomplete fracture (crack).

It is silent and because the victims are going through shock (caught in the disaster «in the heat» can even walk, stepping on the damaged leg).

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Or the same thing will occur because of an uncritical attitude on the part of the victim, which as such does not feel (decrease of pain threshold from the excess of alcohol taken, from taking the drug, as a result of senility).

Indirect confirmation of the diagnosis can also be described by the mechanism of damage to and General condition of the victim (picture of the shock), and the condition of the tissues at the site of injury.

But «put an end» in this question can only radiograph that demonstrates:

  • violation of the integrity of bone (fracture, crack);
  • fracture – the type and nature of fragments and degree of displacement.

Immediate on-site assistance

But for the production of the picture, the victim must go into the facility, but this does not always happen quickly. Therefore, until the arrival of the emergency services, the patient must provide all possible immediate assistance in place (first aid).

Its activities should be aimed at reducing the severity of pain shock. Because it is injured limb, it is necessary to reduce the pain in it.

For this purpose the limb immobilization – giving her the most gentle of the situation with fixing it.

But don’t try to match fragments of your own!

With the aim of immobilization used any means available: Board, stick, rail, scrap pipe, a strip of plastic sheet – anything that can be applied and a bandage to the limb, the lower otlook bones did not move, remaining in place.

If nothing is found, you can gently bandage the injured leg to the healthy.

General rules immobilization: the cessation of movements in at least two joints (above and below the injury) and spacer (insulation material) between the tire and body.

With reduce the swelling of the injured area if it can be cooled by applying snow or ice (no naked bodies!), the same being in shock should be warmed, the warmth of hiding and feeding a hot drink.

When bleeding from a wound above it overlaps with the wiring or twist of the material at hand (with the mandatory attachment of the note about the time of the imposition of styptic) and aseptic bandage on the wound.

If possible (and after exclusion of suspected intolerance), you can give the victim pain reliever.

As a fused bone…

The aim of the treatment is not only to restore the integrity of broken bones, but also the opportunity to continue steady use of the lower limb.

The easiest and most effective means of consolidation of the bone is immobilized by applying plaster bandage. As necessary, monitoring the process of fusion is carried out, producing x-rays of the bone.

When displacement of fragments required to return them to the place – reposition, themselves fragments can be bonded overlay plate, fixed with screws.

Maximum efficiency of treatment and reduce its timing allows us to achieve application of Ilizarov.

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… and how long it fused

Recovery time the integrity of the fibula may depend on the nature of the fracture and other factors:

  • the rapidity and expertise in first aid;
  • age and General health of the patient;
  • from the seriousness of his attitude to medical recommendations

The rehabilitation period takes an average of 2-3 months (when the fracture with displacement up to 6 months), the formation of callus usually occurs after 6 weeks of treatment.

Measures to accelerate rehabilitation after fracture of the fibula may be assigned exercises and hardware impacts to improve circulation in the affected limb, restoring tone her muscles and improve joint mobility (massage, exercise therapy, physiotherapy).

The main condition for the success of rehabilitation is strict adherence to the recommendations of a physician.

Possible complications and consequences

Since the main load in the lower leg falls to the tibia, the consequences of bone fracture in the fibula are most often associated with the frivolous attitude of the patient to his condition and «early walking» on the bad foot.

These include:

  • the consequences of wrong accretions in the form of shortening of the affected limb;
  • the absence of coalescence (or slow accretion) of fragments;
  • the development of arthritis or osteoarthritis in the injured joint.

Complications of fracture should be considered:

  • damage to the peroneal nerve;
  • infection of open wounds;
  • vascular complications (up to a fat embolism in the case of open fractures).

How to protect the bone from fracture

To prevent fractures at all (and lower limbs, in particular) need to think carefully about what is under foot and that the toes.

The first condition means: watch where you step foot (to keep his feet obey the head, and not Vice versa, not to walk around the house and outside-mindedness and deep detachment).

Second, the shoes should be «correct» (based on size, season and convenient) especially the shoes: sports, skate on the rollers or just the skates (for skating on ice).

Under these conditions, as well as regular medical examination the bones are intact.