Walking After Broken Tibia and Fibula: When and How? Recovery Time

walking after broken tibia and fibula

You’ve just been diagnosed with a tibia-fibula fracture and you’re wondering about the recovery time? You’re not sure what to do now that you’ve broken your leg?

Can you still walk with a broken tibia and fibula? How long to walk normally?

As a physiotherapist with over 11 years of experience, I’m here to share my knowledge on rehabilitating broken tibia and fibula.

I’ve also consulted the latest medical studies from around the world to give you the most up-to-date and reliable information possible. All sources are cited at the end of the article.

If you still have questions after reading this article or if you want to share your own experience, please leave a comment!

Enjoy the read 🙂!

Last update: May 2023
Disclaimer: Academy Sport affiliate links

Summary
  • What are the different types of tibia-fibula fractures?
    • When do they occur?
    • What are the symptoms?
  • What is the usual treatment for a tibia-fibula fracture?
    • Plaster cast, walking boot, immobilization?
    • Broken tibia and fibula surgery?
    • Tibia/fibula fracture rehabilitation protocol & physical therapy
  • Can you still walk with a broken tibia and fibula?
    • How learning to walk after broken leg?
    • How long will it take to walk without any support after a tibia fracture?
    • How long to walk normally after broken fibula and tibia?
  • What is the recovery time for a broken tibia and fibula?
    • Length of hospital stay
    • Length of work leave
    • Total healing time
  • How to sleep after a tibia-fibula fracture?
  • Should I be concerned if my foot is swollen?
  • What are the long term effects of a broken tibia and fibula?
    • Non-union or delayed union
    • Infection
    • Decreased functional capacity
  • How long before I can resume sports?

What are the different types of tibia-fibula fractures?

Between the foot and the knee in the leg, there are two bones that are about the same length and located next to each other:

  • The tibia, which is the larger bone
  • The fibula, which is also called the peroneal bone

When both of these bones break at the same time, it’s called a “tibia-fibula fracture” or a “tibia/fibula fracture.”

These bones can break in different ways:

The fractures can also be categorized as:

  • Non-displaced tibia/fibula fracture: where there is little space between the two broken bone fragments, these types of fractures usually recover better and faster than displaced fractures, where the gap between the different bone ends is greater
  • Open tibia-fibula fracture: in which the skin is perforated, and the bones are visible through the wound, requiring prompt surgery to clean the wound and stabilize the fractured bones.

That’s why your medical report may contain more specific information than just “tibia-fibula fracture.”

This article covers tibia-fibula fractures in general, so these general tips are valid regardless of the type of fracture you have. However, your healthcare professionals will personalize your treatment plan based on your specific situation.

It’s rare to only break the fibula. It is common to break both tibia and fibula. In 78% of cases, when there is a fibular fracture, there is also a tibial fracture (Javdan 2017).

A displaced double tibia and fibula fracture, as seen on the X-ray.
A displaced double tibia and fibula fracture, as seen on the X-ray.

When do they occur?

Fractures of the tibia and fibula are more common in:

  • Adolescents and young adults
  • In elderly people

But they can occur at any age, including in babies.

These fractures often happen:

  • In a car accident
  • From a fall (especially in cases of osteoporosis)
  • During sports, particularly soccer or cycling
A complex tibia and fibula fracture as seen on the CT scan. It is highly likely that your injury is less severe than this one! Here, the fracture is located just below the knee, at the top of the tibia.
A complex tibia and fibula fracture as seen on the CT scan. It is highly likely that your injury is less severe than this one! Here, the fracture is located just below the knee, at the top of the tibia. Source: radiopaedia.org

What are the symptoms?

The usual symptoms include:

  • Intense pain in the leg
  • Swelling
  • Bruising
  • Difficulty walking, even putting weight on the affected leg
  • Visible deformation of the leg

A medical diagnosis is made after an examination and X-ray, and sometimes an MRI if a better view of the fracture is needed.

Open tibia and fibula fracture
Open tibia and fibula fracture (X-ray)

What is the usual treatment for a tibia-fibula fracture?

What to do when you have a fracture of the tibia and fibula? It depends on the location and type of fracture, as well as your overall health and the habits of the medical and surgical teams you encounter.

Plaster cast, walking boot, immobilization?

If you’re not undergoing surgery, you’ll receive what’s called conservative treatment. This may involve immobilization or limited movement and weight-bearing.

You may receive a cast or be advised to use a walking boot (see on Academy Sport) without a cast until your follow-up X-ray, or you may simply be instructed to gradually resume your activities based on your pain level without a cast or walking boot.

The more complex and unstable the fracture, the more likely you are to be advised not to put weight on your leg (or only very little) for 6 to 12 weeks, even without a cast, such as with an external fixator.

There’s no data from studies suggesting that a cast, walking boot, or no specific intervention is better (Banerjee 2019).

Broken tibia and fibula surgery?

If you have an open or severely displaced or unstable fracture, it is highly likely that you will have surgery. A device (or several) is then put in place:

  • external fixator,
  • plate,
  • centro-medullary nail,
  • screw.

The operative report precisely indicates the procedure that was performed, and the post-operative instructions to follow, particularly for physical therapy. It also states on which bone the material was placed (tibia, fibula, or both).

This material may be left or removed in the months or year following the operation, especially if it causes discomfort.

Even if you have surgery, you may still be put in a cast or have a walking boot.

X-ray after surgery for a tibia and fibula fracture in a baby. Screws and a plate can be seen.
X-ray after surgery for a tibia and fibula fracture in a baby. Screws and a plate can be seen. Source: Li 2017

Tibia/fibula fracture rehabilitation protocol & physical therapy

There’s no standard rehabilitation protocol for a tibia-fibula fracture, nor any specificities compared to other types of fractures.

Depending on its location and severity, it’ll be about:

  • Answering your questions and reassuring you
  • Maintaining or recovering ankle mobility in case of a fracture at the level of the malleolus
  • Maintaining or recovering knee mobility in case of a fracture at the proximal end of the tibia, under the knee, for example, a plateau fracture
  • Relieving pain, mainly through advice and tricks, in addition to medication. The effect of ultrasound, TENS, or massage is limited.

The role of physiotherapists is to identify with you what you can do daily during this rehabilitation period to preserve your physical (and mental!) abilities: daily gestures, comfortable position, amount of walking, sitting or lying down during a day, etc.

Imagine spending just a few tens of minutes per day with your physiotherapist, and more than twenty hours alone. You’re forty times more often alone than supervised!

That’s why you shouldn’t rely mainly on the time spent with your physiotherapist (even if you’re in a rehabilitation center) but on everything you do during a day!

Hence, the educational and supervisory role of physiotherapists 🙂.

And you won’t spend your days doing repetitive exercises. That’s why your overall physical activity level during a day is more important than doing 3×10 repetitions of a specific exercise!

I know it’s counterintuitive because we all want the “miracle protocol” to follow, with specific exercises to ensure we get better.

However, there’s no evidence that following such a protocol makes a difference. Instead, finding the right dosage of physical activity for you, adapted to your lifestyle, post-operative instructions, and what you’re willing to do, is crucial.

A basic and effective self-exercise to maintain knee mobility at home after a right tibia and fibula fracture is to use a rolling office chair.
A basic and effective self-exercise to maintain knee mobility at home after a right tibia and fibula fracture is to use a rolling office chair. This allows for flexion to be worked on in different ways, such as keeping the right foot fixed on the ground while moving the chair, or moving the right foot backward. The simplest exercises are often the most effective because they are the easiest to implement!

Can you still walk with a broken tibia and fibula?

Yes, you can!

On the same day as the fracture, you can start walking again. You just need to find the appropriate walking aid: crutches, walker, etc.

You’ll know whether or not you can put weight on it. Even if you can’t put weight on it, you can usually still make contact with the ground by lightly resting your foot on it without actually putting weight on it.

Over the weeks, you’ll start walking more and more normally. When the bones are fully healed, you can gradually return to normal walking with as much weight-bearing as your pain and strength allow.

How learning to walk after broken leg?

Learning to walk again after a broken leg can be a challenging and gradual process that requires patience and persistence.

Here are some general steps that can be taken to aid in the process of learning to walk again after a broken leg:

  1. Use assistive devices: Crutches, walkers, and other assistive devices can help support your weight and prevent further injury as you begin to move around again.
  2. If you are having trouble walking with crutches, ask a physical therapist to show you how. Then, practice a little bit every day at home: it will come, and it’s not a big deal if you don’t perfectly follow the way your therapist showed you to walk!
  3. Gradually increase the duration and frequency of your walking sessions.
  4. Stay active: Regular exercise and physical activity can help speed up the healing process and prevent muscle loss and weakness.
  5. Be patient: Learning to walk again after a broken leg takes time and patience. It is important to take things slowly and not rush the process, as this can lead to re-injury and setbacks.

How long will it take to walk without any support after a tibia and fibula fracture?

The time it takes to walk without any support after a tibia and fibula fracture can vary depending on the severity of the injury and the individual’s overall health and fitness level.

Generally, it takes about 1-3 months to recover from a tibia and fibula fracture and to regain full weight-bearing capacity on the affected leg.

The transition from using assistive devices to walking without support is usually a gradual process. In some cases, it may take several weeks or even months of practice before you can walk without any support.

How long to walk normally after broken fibula and tibia?

People with a tibia-fibula fracture usually take 2 to 6 months to walk normally again, like before.

What is the recovery time for a broken tibia and fibula?

When you have a fracture, you’re eager to know how long each step of recovery will take. Here’s an overview.

Length of hospital stay

You’re usually hospitalized if you need surgery, usually for a few days.

Elderly people may be hospitalized even without surgery, but only for a few days, rarely more.

Afterwards, it may be possible to go to a rehabilitation center if the type of fracture and living situation require it. Otherwise, you go home with potentially some physical therapy sessions to do at home or in a clinic.

Length of work leave

The duration depends on your profession and employment status.

If your job requires a lot of standing, the time off work may be longer, up to several months.

If you can work remotely from home on a computer, it’s possible to not take time off, or only for a few days. Of course, you’ll need to adapt your workday to change positions and not sit for 8 hours straight.

The amount of compensation is the same regardless of your condition. It depends on your employment status (employee, self-employed, etc.). You can find this information on the website of the national health insurance and the website of the pension fund you belong to (for example, CARPIMKO for self-employed physical therapists in French).

Total healing time after a tibia/fibula fracture

It’s difficult to say exactly how long it will take to fully recover, as it depends on many factors such as the type of fracture, your current and prior health status, etc.

In general, it takes a few months to fully recover and resume your life at 100%. Here are some recovery timeframes as a reference:

StepTypical recovery time from the day of the fracture
Less pain2-3 weeks
Bones are well consolidated6-8 weeks
Swelling in your leg/foot disappearsSeveral weeks to months
You can walk with crutchesImmediately
You can walk without crutches6 weeks-3 months
You can drive a car6 weeks-12 weeks
You can return to work2-4 months
Sports can be resumed!3-10 months
Full functional and muscular recovery6 months-1 year
These are average recovery times that I observe in my patients after a tibia-fibula fracture.

How to sleep after a tibia-fibula fracture?

It’s normal to feel more discomfort at night than during the day, with more pain, especially in the second half of the night. Several things can explain this:

  • Hormones secretion differs between night and day, impacting our pain and sensitivity
  • We’re more easily anxious at night
  • Inflammation (a natural and healthy process to promote tissue healing and bone consolidation) is more significant in the second half of the night

This will fade over time (a few days to a few weeks at most), and you should find ways to sleep better over time, such as:

  • Using comfortable pillows (such as memory foam or nursing pillows), body pillows to support your back or legs comfortably. You don’t necessarily need to buy something specific; you probably have items at home that could work.
  • Elevating your feet while sleeping (with pillows or by placing objects under the bed).
  • Applying ice.
  • Not covering your fractured leg with your blanket, sheet, or duvet (friction can increase or wake up the pain). To do this, you can simply lift the sheets, support them with pillows, or use bed rails.

Should I be concerned if my foot is swollen?

Even if you have a leg injury, your foot almost always swells after a fracture of the tibia and fibula. And swelling (also called edema) can last for several weeks.

Why does this swelling happen?

  • Because you move less, you activate less blood circulation in your lower limb. So, blood stagnates more, especially down below. Because there is inflammation at the broken part and all around it.
  • This phenomenon is natural and helps your body bring all the necessary substances to the bone and skin tissues, via fluids, to help damaged structures heal as quickly as possible.
  • But since there is more fluid, it swells.

Isolated swelling, not associated with other signs (such as fever or significant redness) is not a sign of alert or complication.

So, here are the five things I recommend to my patients who are bothered by this swelling.

  • Walk as often as pain allows.
  • Use crutches or a walker.
  • Find the most suitable way of walking for you. As soon as possible, go for a walk outside, on gradually longer distances.
  • Limit the time spent standing still or sitting with your foot on the ground. Or standing in place. Because in these moments, blood circulation is less activated than when walking or downhill.
  • Wear compression socks or stockings (see on Amazon) if you have no contraindications and if it seems acceptable and practical for your case. You can buy them at the pharmacy or online. They are covered by health insurance and mutual insurance if you have a prescription from your physiotherapist or doctor (in France).
  • Several times a day, elevate your foot.
  • Sit comfortably on a sofa or bed. If you don’t have an electric bed or chair, use stacks of cushions to position your foot higher than your heart. Arrange the cushions so that your foot won’t slip.

Remember that swelling will decrease over the weeks. No matter what!

What are the long term effects of a broken tibia and fibula?

Many people worry because their fibula fracture is not healing. Usually, they learn this from their follow-up X-ray, a few weeks after the fracture diagnosis. This is relatively common and does not mean that the fracture will never heal: it just needs more time.

The majority of people recover without sequelae after a tibia-fibula fracture.

Delayed or non-union

When the healing is significantly delayed for several months, it is called non-union or delayed union. This happens in 2 to 20% of cases (though the numbers are likely overestimated).

However, it does not mean that the person will be unable to do anything anymore. It can just cause more pain and arthritis in the short or long term (or sometimes never).

Infection

Infection is rare and mainly occurs in cases of open or surgical fractures. The further away from the day of the fracture, the lower the risk.

Decreased functional capacity

Some people may not recover 100% of their pre-injury physical abilities. However, this is the exception rather than the rule, and one can continue to recover even several months after a fracture (although more slowly): “time heals all wounds!”.

How long before I can resume sports?

An study (Taberner 2019) looked at the sport recovery of a English football player from Ligue 1 after a tibia/fibula fracture:

  • 7 and a half months: full-time training resumed
  • 9 months: played 100% of a match
  • 11 months: no longer had any symptoms

For those who love numbers, the entire rehabilitation and retraining process was meticulously quantified.

return to sport after tibia fibula fracture : rehabilitation protocol
Honestly, I have strong doubts about the usefulness of quantifying recovery to such an extent, except for research purposes (and even then…).

There are no general data for athletes. From my experience, it takes:

  • 2-4 months to slowly return to sports for non-displaced, less serious fractures. For more serious fractures, it’s more likely to be 4-6 months.
  • Between 6 months and 1 year to return to pre-injury intensity and frequency.

THE BOTTOM LINE

On the same day as the fracture, you can start walking again. You just need to find the appropriate walking aid: crutches, walker, etc. The transition from using assistive devices to walking without support is usually a gradual process. In some cases, it may take several weeks or even months of practice before you can walk without any support.

***

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 ðŸ“š SOURCES

Thompson JH, Koutsogiannis P, Jahangir A. Tibia Fractures Overview. [Updated 2022 Aug 1]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-.

Epidemiology. Clelland SJ, Chauhan P, Mandari FN. The epidemiology and management of tibia and fibula fractures at Kilimanjaro Christian Medical Centre (KCMC) in Northern Tanzania. Pan Afr Med J. 2016 Sep 29;25:51. doi: 10.11604/pamj.2016.25.51.10612. PMID: 28250875; PMCID: PMC5321146.

Cast, walking boots. Banerjee S, Ryce A. Orthotic Walking Boots for Patients with Fractures or Ligament Injuries: A Review of Clinical Effectiveness and Cost-Effectiveness [Internet]. Ottawa (ON): Canadian Agency for Drugs and Technologies in Health; 2019 Sep 9. Available from: https://www.ncbi.nlm.nih.gov/books/NBK549526/

Surgical treatment Javdan M, Tahririan MA, Nouri M. The Role of Fibular Fixation in the Treatment of Combined Distal Tibia and Fibula Fracture: A Randomized, Control Trial. Adv Biomed Res. 2017 Apr 25;6:48. doi: 10.4103/2277-9175.205190. PMID: 28620592; PMCID: PMC5433694.

In babies. Li J, Pan Z, Yan S, Zhao X. Single-cortex is better than double-cortex in fibula grafts for large tibia bone defect in a 2-year-old child: A case report of a successful surgery and discussion of bone graft choices. Medicine (Baltimore). 2017 Feb;96(5):e5965. doi: 10.1097/MD.0000000000005965. Erratum in: Medicine (Baltimore). 2017 Aug 11;96(32):e7809. PMID: 28151885; PMCID: PMC5293448.

Complication : infection. Zhao J, Yang J, He X, Qin D, Fang L. Etiological spectrum and treatment outcome of wound infection in patients with open tibia and fibula fractures. Am J Transl Res. 2022 Oct 15;14(10):7208-7216. PMID: 36398265; PMCID: PMC9641439.

Return to sport. Taberner M, van Dyk N, Allen T, Richter C, Howarth C, Scott S, Cohen DD. Physical preparation and return to sport of the football player with a tibia-fibula fracture: applying the ‘control-chaos continuum‘. BMJ Open Sport Exerc Med. 2019 Oct 30;5(1):e000639. doi: 10.1136/bmjsem-2019-000639. PMID: 31749984; PMCID: PMC6830476.

photo de nelly darbois, kinésithérapeute et rédactrice web santé
By Nelly Darbois

I love to write articles that are based on my experience as a physiotherapist and extensive research in the international scientific literature.

I live in the French Alps 🌞❄️ where I work as a physiotherapist and scientific editor for my own website, where you are.

4 thoughts on “Walking After Broken Tibia and Fibula: When and How? Recovery Time

  1. Hi thank you for your article It was very informative. I was recently cleared at 12 weeks with a fully healed bone for my broken tibia plateau fracture but it is very painful beginning walking the first few days weren’t that bad but now that I’ve done it for a while it’s getting worse. Am I overdoing it or is this a normal part of recovery? Especially around the knee area and back of shin.

    1. Hi Silvia,
      Thank you for your feedback!
      Pain on resuming walking happens quite frequently. That doesn’t necessarily mean there’s a problem. However, it’s difficult to say more without a precise assessment! Don’t hesitate to talk to your healthcare professionals,
      Kind regards

  2. I was so happy to find this article!! I was run over just under à week ago, my fibia and tibia where clean broken, so I had surgury a day after, where they inserted a pole into the bone and screwed it together, they went in through my knee and ankle.
    I’ve since been sent home. I’m using a walker to get round at this time hopping from place to place as the thought of putting my foot flat on the floor just feels impossible at this time let alone any pressure!
    I have to say it takes a toll on feeling so down and useless, mundane things we take for granted in everyday life like going to the bathroom is a carefully planned out possess and incredibly tiring, I cant wait to feel normal again!!
    So I just wanted to thank you for this article, its positive and uplifting and made me feel so much better about days to come! Wonderful!!!

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