What is a spiral fracture?
A spiral fracture, also known as torsion fracture, is a type of complete fracture. It occurs due to a rotational, or twisting, force.
Complete fractures are categorized based on the way the bone breaks. Categories include:
However, it always results in the bone being separated into two distinct pieces.
In a spiral fracture, the broken bone resembles a corkscrew or a winding staircase, because the break happens diagonally across a bone that is longer than it is wide.
For a bone to break this way, the force that results in the break is usually considered high energy, meaning it’s caused by a great force.
A spiral fracture can be either displaced or stable. In a displaced fracture, the parts of the bone at the break no longer line up correctly. In a stable fracture, the parts of the bone line up and are barely out of place.
What are the symptoms of a spiral fracture?
The most common and obvious symptom of a spiral fracture is a pain in the injured area. The type of pain depends on the severity of the injury. People have characterized the pain as dull, heavy, and agonizing.
There may also be:
- bone stiffness
- restricted range of motion
- swelling and redness
In the case of an open fracture — a fracture where there is a break in the skin — you may see jagged bones and bone fragments, in addition to bleeding.
What are the causes of a spiral fracture?
Spiral fractures can occur when one extremity, such as your foot, is planted while your body remains in motion. These are commonly the result of sports injuries or falling from a short distance. While spiral fractures can occur in any long bone, they are most commonly found in the tibia.
When these fractures occur in preschool-age children, they are referred to as toddler’s fractures. Toddler’s fractures are a common sign of physical abuse because they are a result of jerking or forceful twisting of a limb. Greenstick fractures are another common type of fracture that happens in children, because of how soft their bones are.
Spiral fractures are most likely to occur in these bones:
- tibia, or shinbone
- fibula, or the short bone in your calf that is parallel to the tibia
- talus, located in your ankle between the tibia and fibula
- femur, or thighbone
- humerus, or the bone in your upper arm
- bones in your fingers
How is a spiral fracture diagnosed?
In the case of a spiral fracture, it’s important that you tell your doctor exactly how the injury happened, as this can help them pinpoint the type of fracture you have.
Your doctor will perform a full physical exam, focusing on the affected area. They will check for obvious irregularities by both looking at and feeling the limb, such as:
- breaks in your skin
If your doctor thinks it’s necessary, you will then undergo X-rays and a CT scan.
X-rays can confirm that the bone is broken and show if the break is displaced or stable. CT scans can show your doctor if there is damage in nearby joints and provide additional information about the fracture.
How is a spiral fracture treated?
Because of the way in which a spiral fracture occurs, the resulting broken bone usually has jagged edges. This can complicate the healing process. It’s also possible that the injury results in detached bone fragments, which can make treatment even more difficult. For these reasons, treatment will depend on the severity of the break and whether the bone is displaced or stable.
Treatment for a stable spiral fracture
If the spiral fracture is stable, treatment will usually involve keeping the bone immobilized with a cast for a period of four to six weeks. A stable fracture is generally more common in children.
Treatment for a displaced spiral fracture
Because of the jagged bones that characterize a displaced spiral fracture, more often than not surgery is required for treatment.
Your doctor will perform what is known as an open reduction surgery. In this procedure, you are put under general anesthesia. Next, your doctor opens up the affected area to set the parts of the bone in place.
During the operation, your doctor continues to assess the severity of the injury. For example, if there is damage to the surrounding muscles or blood vessels, your doctor also evaluates and treats these injuries. Your doctor then realigns the broken bone and sets it in place with either rods, pins, or screws, all of which can be permanent or temporary.
Recovery from surgery
After an open reduction surgery, a cast is usually applied to the limb. It will be removed after a period of a few weeks.
Especially in the case of surgery, recovery can be rather painful. Ibuprofen (Advil) and other nonsteroidal anti-inflammatory drugs have been shown to slow down the healing process. As a result, acetaminophen with codeine is more commonly prescribed.
Physical therapy can be another important part of healing your fracture. Because of wearing a cast, you’ll likely lose some strength and range of motion. You can gain them back in the affected limb through exercise and various other treatments.
What is the outlook for a spiral fracture?
Bones grow very slow, so many spiral fractures take about four to six months to heal. Prompt treatment is important for proper healing. If you suspect you have a spiral fracture, see your doctor right away to get evaluated.