Does a fibula fracture require surgery?

The human body may develop some conditions due to fractures in multiple parts, which will cause adverse effects on the body. For example, after a fibula fracture occurs, the patient needs to undergo surgery to reposition it, and then external fixation to prevent dislocation, fix the bones, and prevent the bones from cracking again. In addition, it is also necessary to understand the symptoms of fibula fractures so that they can be discovered and treated in time.

Treatment methods The treatment of this disease mainly includes the following aspects:

(I) Manual reduction and external fixation: After successful anesthesia, two assistants perform traction and counter-traction on the knee and ankle respectively. The surgeon uses both hands to push, squeeze and pinch the broken bone ends according to the direction of displacement under fluoroscopy to reduce the fracture. After reduction, a small splint or long leg plaster can be used for fixation.

(B) Bone traction: For cases of oblique, spiral, comminuted, and other tibia and fibula fractures, the bone ends are very unstable and it is difficult to maintain a good alignment after reduction. There are also wounds at the muscle fracture site, skin abrasions, and severe swelling of the limbs. The limb must be closely observed and cannot be immediately fixed with a small splint or plaster splint. It is best to use continuous traction on the calcaneus.

(III) Extraosseous pin fixation.

(IV) Open reduction and internal fixation.

Local pain, swelling, and deformity are more obvious, showing angulation and overlapping displacement. Attention should be paid to whether there is damage to the common peroneal nerve, anterior tibial artery and posterior tibial artery, and increased tension in the anterior tibial and gastrocnemius areas. Complications caused by fractures are often more serious than the consequences of the fracture itself.

Second, diagnosis:

Due to the superficial location of the tibia and fibula, diagnosis is generally not difficult. The displaced bone ends can often be palpated in the painful and swollen area. It is important to promptly discover damage to the anterior and posterior tibial artery and vein and the common peroneal nerve associated with the fracture. The pulsation of the dorsalis pedis artery, foot sensation, and whether the ankle joint and big toe can dorsiflex should be recorded as routine records during the examination. For those with more serious local injuries such as crush injuries, open fractures, and those who have had tourniquets on for a long time or have been bandaged too tightly, special attention should be paid to observing whether the injured limb has progressive swelling, especially in muscle-rich areas. If the skin is tense, shiny, cold, blistered, the muscles are hard, the dorsalis pedis artery cannot be palpated, and the limbs are cyanotic or pale, these are manifestations of fascial compartment syndrome and should be treated urgently.

Traumatic tibia and fibula fractures are most likely to be accompanied by major vascular injuries, as they are mostly caused by major violence, so the injuries are usually serious and are often accompanied by injuries to other parts of the body and internal organs. After tibia and fibula fractures are combined with vascular injuries, the muscle-rich calf muscle tissue is extremely susceptible to involvement, because skeletal muscle is more sensitive to ischemia. It is generally believed that limb muscle tissue can degenerate and necrotize after 6 to 8 hours of ischemia; if there is also damage to the soft tissue itself, the safe time limit for tolerating ischemia will be even shorter; moreover, severe soft tissue injury and sepsis caused by postoperative wound infection also greatly increase the risk of amputation.