Fibula Stress Fractures: A Systematic Review

Area of Science:

• Orthopedics
• Sports Medicine
• Traumatology

Background:

• Fibula stress fractures are common in athletes and military personnel.
• Limited large-scale studies exist for treatment.
• This review synthesizes current literature for evidence-based recovery expectations.

Purpose of the Study:

• To evaluate and present literature on fibula stress fractures.
• To establish evidence-based goals for return to activity.
• To set realistic expectations for injured patients.

Main Methods:

• Systematic literature search across 3 databases (2010-2022).
• Adherence to PRISMA protocol and Cochrane Handbook guidelines.
• Inclusion criteria focused on fibula stress fractures, excluding pediatric, non-English, and incomplete data studies.

Main Results:

• 3 studies with 10,987 subjects were analyzed.
• 45 cases (8.6%) of fibula stress fractures were identified among 521 total stress fractures.
• All fibular stress fractures healed nonoperatively by an average of 7 weeks, with return to activity by 9 weeks; no nonunion or delayed union reported.

Conclusions:

• Fibula stress fractures have a moderate incidence (up to 8.6%) among all stress fractures.
• Nonoperative management with activity modification leads to successful healing.
• Patients can anticipate returning to baseline activities within 9 weeks, aiding in setting realistic recovery goals.