Pain in leg several months after broken fibula

I have uploaded my first x-ray as my avatar, I was in a plaster cast up to my knee for the entire 1.5 months, the pain can be just a slight annoyance or it can cause me to limp if i'm walking. Also i'm not sure but I think during the periods of pain my ankle clicks more often

BenC1992,

You have to remember that you do not just break the bone, but the soft tissues are also damaged. You probably have some scar tissue within the muscles of the lateral compartment. This can cause problems when you use the muscles a lot.

If you have not had a recent x-rays, you may also want to get some, to see if the bone has healed completely.

The fibula is not a weight bearing bone, and as such is considered an expendable bone. In fact, the midshaft portion of the fibula is often harvested as a vascularized bone graft, for use somewhere else in the body.

But, if the bone has not healed, and it is causing significant problems, it may have to be addressed.

The only way to know, it to see your orthopedic surgeon for an evaluation and maybe some new x-rays.

Good luck.

I went into my doctors surgery today for a nurses appointment to get a referal to our local hosiptals orthapedic deparment's fracture clinic and I was able to get a look at the report my doctor made from my last check-up at the hosipital. He said in this report that the was risk of a malunion fracture which could cause me trouble in the future, even though at the time I recall asking him if it would heal correctly and he said it would. It turns out the open appointment I was given in mid-november was still available so I should be heading into hospital soon to get my leg looked at.

BenC1992,

With the segmented fracture that you have, it is possible that you could develop a malunion. This just means that the bone does not heal completely straight.

Again, the fibula is a strange little bone. Some patients do develop some problems because of the muscles that attach to it. But, that is more of a soft tissue problem than a bony one.

Usually, if patients have problems after healing of a fibula fracture, a couple of things can be done, depending upon how much intervention the patients want to employ. It is possible to go in and rod or plate the bone (hard to do because it is so small in diameter). This is a big operation and some patients develop problems from the scarring of the soft tissues that develops during healing. Another option is to do a fibular osteotomy. This is basically just taking out a small section (about 2 cm). But, again, this is usually done for patients that have just a single break.


If you are going to have to wait till November, you should work on rehabing the leg till then. Occasionally, with time, the scarring in the muscles around the fibula will mature and soften, and the patient may actually start to feel less discomfort.

But, if you do not, at least you have the appointment scheduled. But, do the rehab, because that is what the surgeon will usually recommend as the first step. So, if you have already done that, it will save you some time.

Again, usually, the fibula is not addressed, because they almost universally heal without problems. The only parts of the fibula that are structurally needed are the ends, where it makes up part of the ankle joint and at the knee (where the collateral ligament of the knee attaches). The midportion is expendable.


Anyways, good luck. Hope your discomfort decreases with rehab. If not, hope they can do something without too much effort. Wishing you the best.

I've got a appointment to see an orthopedic surgeon on the 5th July and I'm fortunate still be covered by my families private health insurance from my dads work, so hopefully I shouldn't be waiting till November to get it sorted if it needs it. Already done some research on some appropriate exercises to do to help strength the affected area and have started to do these daily.

Ben,

Great. From your previous note, it sounded like you had to wait till November, it is great that you have an appointment next month.

Work on the stretching of the muscles in the lateral compartment and keep in mind what activities cause you the most problems (so you can tell the surgeon).

Good luck. Wishing you the best.

A friend a 61 year old woman who broke her arm in a fall 11 months ago says she is in severe debilitating pain to this day. The bone did take longer than usual to heal because she was taking a drug for osteoporosis but is said to be healed now. She is convinced that if the bone had been operated and wired rather than immobilized she would not be suffering the severe pain she describes now. She has been to a chronic pain clinic but she refuses to do the MRI they require as she says she is in too much pain to submit to this procedure. Does any of this follow a predictable pattern

Forbes,

Sorry to hear that your friend is having problems.

Unfortunately, patients often do not realize that when a bone is fractured, it is not the only tissue which is damaged. When a bone breaks, the periosteum (the soft tissue sheath on the outside of the bone) is ripped apart, the muscle attachments are torn off, the fascia is stretched, as are the nerves and blood vessels. All this soft tissue damage also has to heal, which it does with the formation of scar tissue. Of course, scar tissue does not act as the tissues normally would.

If she had such significant osteoporosis, that she needed to be on medication, she would most likely have not done well with surgical intervention. The application of a plate and screws depends on the security of the screws going into the bone. Unfortunately, screws do not hold well in osteoporotic bone. It is akin to putting screws into cork or Styrofoam. They just pull out. So, the internal fixation construct just fails. And the patient has now gone through a surgical procedure which would place nerves at risk, form more scar tissue, only to fail. Thus, if a patient has very significant osteoporosis, surgical fixation is often not a viable option.

Also, surgery does not speed up the healing of bones. If fact, when a DCP (dynamic compression plate) is used on a long bone fracture, it causes the bone to heal by primary endosteal ossification, which actually takes longer than with the formation of callus (when fractures are just immobilized).


It is unfortunate that your friend continues to have problems after her injury. But, it sounds as if she was treated (and is being treated) appropriately. When patients have continued pain in the region of a fracture, you have to make sure that the bone is healed, which is sometimes difficult to tell on just flat film x-rays.

If she is unable to tolerate laying in an MRI machine for an hour, perhaps a CT scan (which can be done is just a few minutes) would provide the surgeon with the information needed. Also, in some cases, patients can be sedated for an MRI. But, this is only usually done if the study is really needed (life threatening situation).

So, at this point, she is sort of limited in what her surgeons can do for her. Pain management is probably the best route to go. But, unfortunately, most of the management of pain comes from the attitude of the patient and it sounds like she is bitter about her injury and is trying to deflect the situation (‘well, I would not have these problems if I was operated on.’ When in actuality, she may have been worse off if the construct failed and she had to have multiple operations for years of time.) Also, pain management is just that, management, it is not just giving out pills to snow the patient. It is designed to help the patient be more functional (not pain free - no such thing).


Again, sorry that your friend is having problems, but at least her humerus (I assume it is the humerus, since you said the bone in the arm, not forearm) is now healed. The rest she can work on.

Wishing you and your friend the best. Good luck.

I broke my fibula just above the ankle 1 year ago while ice skating. I want to go back to ice skating. I'm finding that my leg around the brake zone is really sensitive to pressure from the ice skates and other high boots. It aches. It is Is this normal? Will this be my new normal? Any suggestions would be helpful to get me back active and pain free.

rate,

Sorry about your accident.

If the discomfort is significant enough to keep you from doing activities which you want to do, you should see your orthopedic surgeon again for an evaluation (if you have not already).


Usually, once the bone is completely healed, it should not longer be tender. The soft tissues around the fracture site can remain tender for some time after a break. But, this tends to get better (but can actually take a couple of years or more).


You might also want to check on the fit of your skates. If the boot is placing pressure directly on the fracture site, you might want to pad the area with some medical foam or felt.

Actually, most patients with a distal fibular fracture find that high boots, which lace up tightly, feel better than low cut shoes. It may be that it is just the support they provide.


You do not say how the fracture was treated. If you have a plate on the fracture, it is not uncommon for fibular plates to be proud, causing problems with shoe wear. If you do have a plate in place, and the bone is completely healed, you may need to have the plate removed.


But, again, if you have not seen your orthopedic surgeon recently, you may need to see him/her from an evaluation.

Good luck.

Thank you Gaelic!
I had a clean fracture. The fibula was still in position and did't require a plate. I was non-weight bearing for 6 weeks and then used a boot for several more weeks.

It is helpful to know that soft tissue takes some time to heal. This may explain the tenderness.

Now that I think about it, it is not surprising that the figure skates put pressure exactly on the spot I broke, since I was wearing them when I broke my leg.

I like boots that lace tightly around my ankle for the support they provide. The problem is that I have 2E toes and midfoot and a narrow heal, ankle and shin. Although my feet are wide, they are thin from sole to top. Shoes do not fit me. This has contributed to chronic instability. You've helped me identify that because my heels are loose in the skates (and all shoes), my foot can rotate in the skate and the tight spot occurs at the break site where my ankle comes to hit something solid. I need to buy custom shoes and athletic wear or find a way to fill in the heel area so my feet and ankles are held firmly. This will distribute the pressure and help me stay stable. I am working with an orthotics fitter/athletic trainer to try to solve this issue and using my creativity. Finding custom shoes is not so easy and I enjoy many different sports, so a good solution is importatnt for me to stay active.

I love to be active and have always tended to plow through pain. Now I am trying to pay attention to it so that I can protect my feet and health for many years to come.

Your input is most helpful.

rate,

No problem.

You might try heel cups in your shoes/skates since you have a narrow heel. Or you can fashion something custom out of medical felt or foam. There are ways to make the footgear fit. Hope you can something that works so you can get back to skating.

Good luck.

I also broke my fibula about 5 months ago. At one point my ankle felt at 90% now I'm back to having the strong weak achy feeling when walking and can't walk longer than 10 minutes before I start limping and feeling pain. Also now my thigh seems to get a tingly numbing feeling as well I don't know if it has to do with my walking habit but for about 2 weeks my entire leg felt like pins and needles. But now it only occurs when I walk for long periods of time. I feel like the healing process is going backwards even sometimes feeling pain and feeling like my leg is still swollen in a cast as I sleep at night sometimes. Is this normal? Should I be concerned?

tpperk89,

It sounds like you are developing some type of neurological problem. The feeling of the limp being swollen and the entire leg having numbness/tingling, is caused by a nerve problem.

This could be from a spinal condition or a peripheral nerve problem. If the symptoms continue, you need to see a spine surgeon.

Good luck.