Management of Nondisplaced Distal Fibula Fracture

Initial Assessment and Management

The American Academy of Orthopaedic Surgeons recommends confirming the fracture is truly nondisplaced and stable, as management decisions are based on fracture characteristics and patient factors 2, 3
Ensuring neurovascular status remains intact throughout treatment is critical, as this is a critical factor in determining management approach 4
Nonsurgical management is appropriate as the primary treatment for minimally displaced fractures like the one described 5

Rigid immobilization with a below-knee cast or boot is the recommended management approach for a nondisplaced, mildly comminuted fracture of the distal fibula metaphysis with good neurovascular status 1
The American Academy of Orthopaedic Surgeons recommends using rigid immobilization (cast or walking boot) for this nondisplaced distal fibula fracture 1
Rigid immobilization helps prevent displacement and promotes proper alignment during healing 2

Immobilization should typically be maintained for 4-6 weeks, with radiographic follow-up 3
Radiographic evaluation is recommended at initial presentation 2, 1-2 weeks after immobilization to ensure maintained alignment 1, and at cessation of immobilization 3

Clinical and radiographic assessment should be performed to monitor fracture healing 6
Reducing the frequency of radiographic follow-up may not negatively impact outcomes, provided clinical assessment is appropriate 6

Surgery is generally not indicated for nondisplaced fibula fractures with good alignment 3
Consider surgical intervention only if the fracture displaces during follow-up with >3mm shortening or significant angulation 2, or if the patient has specific functional demands requiring earlier mobilization 6

After the immobilization period, progressive weight-bearing and range of motion exercises should be initiated 1
Physical therapy may be beneficial to restore ankle function and strength 2