Treatment of Distal Fibula Fractures
Initial Assessment and Classification
- Fractures should be classified based on displacement, dorsal tilt, and presence of intra-articular involvement, with significant displacement defined as >3mm and dorsal tilt >10° 1, 2
- Radiographic evaluation is essential for confirming diagnosis and fracture pattern 2
Treatment Algorithm
- For non-displaced or minimally displaced fractures, removable splinting is appropriate with a typical immobilization period of 3-4 weeks, and active finger motion exercises should be performed immediately following diagnosis to prevent stiffness 1, 2, 3
- Radiographic follow-up is recommended at approximately 3 weeks and at the time of immobilization removal to confirm adequate healing 1, 2
Post-Operative Management
- Following stable fracture fixation, early wrist motion is not routinely necessary, and when external fixation is used, limiting the duration of fixation is recommended to reduce complications 1, 3
- A home exercise program should be prescribed for rehabilitation 4
Prevention of Complications
- Active finger motion exercises are crucial to prevent stiffness, which can be very difficult to treat after fracture healing 1, 3
- Monitor for potential complications such as skin irritation or muscle atrophy, which occur in approximately 14.7% of immobilization cases 1, 2