Management at 8 Weeks Post-Distal Fibula Fracture
At 8 weeks post-distal fibula fracture, patients should transition to full weight-bearing with continued rehabilitation exercises focusing on strengthening and range of motion to restore optimal function. 1, 2
Assessment at 8 Weeks
- Confirm radiographic healing with follow-up imaging if not already done, as most distal fibula fractures show adequate healing by 8 weeks 1, 2
- Evaluate for any residual pain, swelling, or limitations in range of motion that may require additional interventions 1
- Assess functional status including gait pattern, ability to navigate stairs, and perform daily activities 3, 2
Rehabilitation Protocol
- Progress to full weight-bearing if not already achieved, as studies show that stable fixation with anatomically contoured plates can support full weight-bearing without complications 2
- Continue active range-of-motion exercises for the ankle joint to improve mobility and prevent stiffness 3, 1
- Implement strengthening exercises for the ankle, focusing on all planes of motion to restore stability and function 3, 1
- Incorporate balance training and proprioceptive exercises to reduce the risk of falls and improve functional outcomes 3
- Advance to more challenging exercises including resistance training and functional activities specific to the patient's goals 3, 1
Activity Progression
- Resume normal daily activities as tolerated, with gradual return to more demanding physical activities 1
- Above chest level activities may be resumed as fracture healing is evident by 8 weeks 3
- For athletes, sport-specific training can begin with gradual progression based on functional performance and absence of pain 4
- Monitor for any signs of stress reaction with increased activity levels, especially in athletes returning to high-impact sports 4
Potential Complications to Monitor
- Joint stiffness is one of the most functionally disabling adverse effects and may require more intensive therapy if present 3, 1
- Assess for any signs of hardware-related discomfort that might indicate need for removal, though this is typically not considered until at least 12 months post-surgery unless symptomatic 5
- Monitor for any signs of delayed union or non-union, although these are rare with appropriate initial management 4
Follow-up Recommendations
- Schedule final follow-up appointment to confirm complete healing and functional restoration 1
- Consider discharge from orthopedic care if radiographic healing is confirmed and functional status is satisfactory 1
- Provide guidance on long-term joint protection strategies and activity modifications if needed 3
Special Considerations
- For patients with comorbidities affecting bone healing (e.g., diabetes, osteoporosis), more cautious progression may be warranted 3
- Consider vitamin D and calcium supplementation for patients at risk of osteoporosis to support bone health 3
- For elderly patients, incorporate fall prevention strategies into the rehabilitation program to reduce risk of subsequent fractures 3