Spiral Fracture: Causes And Treatment

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How does a spiral fracture differ from other kinds of bone breaks? Read on to find out more in this article.
RELATED: What Is Boxer’s Fracture? Symptoms, Causes, And Treatment
In this article:

  1. What Is a Spiral Fracture?
  2. Where Do Spiral Fractures Occur?
  3. What Are the Other Types of Complete Fractures?
  4. When Does a Spiral Fracture Happen?
  5. What Are the Symptoms of a Spiral Fracture?
  6. How Is a Spiral Fracture Diagnosed?
  7. What Are the Possible Complications of an Untreated Spiral Fracture?
  8. How Is Spiral Fracture Treated?
  9. Who Needs Surgery?
  10. What Happens After a Spiral Fracture Surgery?
  11. How Can I Help Speed Up the Healing of My Fracture?

What Is a Spiral Fracture? | Causes, Symptoms, Treatment, and Recovery

What Is a Spiral Fracture?

A spiral fracture, also called a torsion fracture, is a complete fracture that happens because of a twisting or rotational injury. Basically, when a long bone is twisted by a strong force, it shatters and causes a spiral fracture.
This kind of fracture mostly occurs on long bones resulting in two separate pieces of bones whose breaks distinctly resemble a winding staircase or a corkscrew. This happens because the break occurs diagonally across the long bone.
There are two kinds of spiral bone fracture:

  • Displaced spiral fracture – The parts of the broken bone do not line up correctly anymore. These may be difficult to realign, as the bones may also shatter or break the skin.
  • Stable spiral fracture – The parts of the broken bone still line up and are minimally misaligned. These are relatively easier to treat because they don’t often break into shards, and are aligned.

Where Do Spiral Fractures Occur?

Spiral fractures are most likely to occur in these bones:

  • Tibia (the shinbone)
  • Fibula (the shorter calf bone parallel to the tibia)
  • Talus (the ankle bone between the tibia and fibula
  • Femur (the thigh bone)
  • Humerus (the bone in your upper arm)
  • Bones in your fingers

What Are the Other Types of Complete Fractures?

Other types of complete fractures include:

  • Comminuted – When a bone breaks or splinters into more than two fragments. This type of complete fracture often requires a powerful force, such as the high-impact trauma brought on by vehicular accidents.
  • Oblique – A common type of a complete fracture wherein the bone breaks diagonally. It usually occurs on long bones such as the tibia or femur.
  • Transverse – When the break is at a right angle or in a straight line across the long plane of the bone
  • Longitudinal – Occurs parallel along the entire length of the bone

When Does a Spiral Fracture Happen?

Anything that may exert extreme twisting or rotational force on a long bone may cause a spiral fracture.
This usually happens when a limb, like a foot, remains still and grounded while the body is in motion. This can bring extreme pressure on the foot leading to the fracture.
So, what exactly causes a spiral fracture?
Spiral fractures are commonly the result of sports injuries or falling accidents.
In children, spiral fractures are called toddler’s fractures and are a common sign of physical abuse—a result of forceful twisting of a child’s limb. It can also be because of a nutritional deficiency and metabolic bone disorder called rickets.

Rickets Definition: A skeletal condition caused by a lack of calcium, vitamin D, and/or phosphate

Common activities which result in spiral fractures in adults include:

  • Snowsports (skiing or snowboarding) wherein the leg can get twisted in a ski or boot
  • Soccer and American football, when players become entangled
  • Wrestling injuries resulting from twists and submissions
  • Vehicular accidents
  • Falling and repositioning
  • Physical violence
  • Heavy machinery operation injuries

What Are the Symptoms of a Spiral Fracture?

A person with a spiral fracture will experience pain and swelling on the side of the injury. As with any other fracture, the more severe it is, the more painful it will be.
Other symptoms include:

  • Restricted range of motion
  • Loss of control and feeling in the lower leg or arm
  • Bone stiffness
  • Tenderness
  • Loss of consciousness
  • Inability to put weight on the injured bone
  • Inability to fully extend the leg or arm
  • Signs of bruising
  • Bone tenting (in open fractures, the fractured bone is ready to break through the skin)
  • Loss of pulse in the ankle or wrist

RELATED: Tibial Plateau Fracture FAQ: Everything You Need To Know

How Is a Spiral Fracture Diagnosed?

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Diagnosis of spiral fractures

If you got injured and may potentially have a spiral fracture, you should tell the doctor about the events leading to the injury. This will help the doctor in accurately identifying the type of fracture sustained.
The doctor will then proceed to perform a physical exam on the site of the injury checking for the following:

  • Swelling
  • Tenderness
  • Deformity
  • Range of motion restriction

The doctor will order an X-ray and/or CT scan after to confirm the kind of fracture and to check if there is damage in the nearby joints.
X-rays definitively show if the injury is a displaced spiral fracture or a stable spiral fracture. CT scans are responsible for showing if there is any damage to the nearby areas

What Are the Possible Complications of an Untreated Spiral Fracture?

Fractures can be life-threatening if left untreated. Here are associated complications for an untreated spiral fracture:

  • Compartment syndrome
  • Blood vessel and nerve damage
  • Muscle damage
  • Infection
  • Sepsis
  • Non-union or malunion, when the bone does not heal or heals incorrectly
  • Pulmonary emboli

Compartment Syndrome Definition: A condition where pressure from swelling or inflammation blocks blood flow to the affected limb. This can lead to tissue damage and other complications.

Sepsis Definition: A condition where an overstimulated immune system (usually by severe infection) starts damaging other tissues

Pulmonary Emboli Definition: A blockage of an artery in the lungs due to a blood clot

How Is Spiral Fracture Treated?

After the injury happens, do not put any weight on the fracture. It should be splinted, if possible, to prevent it from worsening.
Call for professional help right away and request for an ambulance to get the fracture examined and treated in a hospital. While waiting for the paramedics, you can follow the following:

  • To limit inflammation and reduce blood flow, elevate the fractured limb to heart level. Only apply ice for less than 10 minutes at a time.
  • Do not take anti-inflammatory drugs as this may worsen internal bleeding. The only recommended over-the-counter medicine for the initial treatment of a fracture is acetaminophen.
  • Do not eat or drink anything after the injury as surgery may be required.

Spiral fracture treatment depends on how severe the break is and the amount of damage to the surrounding tissues and blood vessels.
Since the broken bones in a spiral fracture have jagged edges, the healing process can become more complicated. The injury may also result in detached bone fragments making treatment harder.
Stable spiral fractures treatment involves immobilizing the bone with a cast for four to six weeks. This generally happens more often in children.

Who Needs Surgery?

Displaced spiral fractures, due to the jagged bones, more often than not require an open reduction surgery. Closed reduction surgery is also possible.
Types of surgery for displaced spiral fractures:
Open Reduction Surgery
In an open reduction surgery, a surgeon will set the broken bone in place while the patient is under general anesthesia. When needed, this may also be done with the use of screws, rods, and pins to keep the bone aligned, which can be either temporary or permanent.
Closed Reduction Surgery
If the bone isn’t separated, the doctor may opt for closed reduction surgery. This involves guiding the bone back into proper alignment from the outside through the patient’s skin.
For patients with stable spiral fracture, surgery is often unnecessary because of the alignment of the bone. Treatment involves immobilizing the bone with a cast for 4-6 weeks.

What Happens After a Spiral Fracture Surgery?

A splint is commonly used after surgery to reinforce the right alignment of the bones. For the first few weeks post-operation, immobilizing the bone completely is crucial for healing.
The usual care followed post spiral fracture surgery is the RICE method:

  • Rest the affected part, e.g. leg
  • Ice compress
  • Compress using an elastic bandage or ace wrap
  • Elevate the injured bone

After a few weeks, doctors may recommend the use of a brace which is easily removable for cleaning, exams, and physical therapy. Patients may also need to use crutches, walkers, or wheelchairs to protect the limb from stress and weight.
Recovery can become painful but taking pain relievers is not ideal as they may slow down the healing process. Doctors usually prescribe acetaminophen with codeine to manage the pain.
Spiral fracture healing time takes about 4-6 months. In severe cases, it may take as long as 18 months.
Patients usually undergo physical therapy to regain full range of motion and strength. Having your arm or leg in a cast for months at a time can result in the loss of muscle mass and range of motion.
With physical therapy, you undergo gradual limb exercises and strengthening exercises can help patients regain their strength.

How Can I Help Speed Up the Healing of My Fracture?

How you react after an injury may affect the gravity of the incurred damage.
If you suspect any kind of fracture, the first and most important step to take is to immobilize the body part. Use any smooth and stable object, like a flat board, as a splint.
Learning a few essential spiral fracture must-dos may also prevent it from worsening, making the treatment for it go more smoothly and efficiently:

  • Take acetaminophen instead of anti-inflammatory pain relievers. Inflammation is an essential part of bone healing, so getting rid of it by taking medicine may slow down the healing process.
  • Vitamin B6, C, D, and K, omega-3 fatty acids, quercetin, and protein supplements may also help in the repair process.
  • Silicon, zinc, calcium, copper, and phosphorus supplements may provide your body the building blocks needed for bone recovery.

Part of keeping your bones healthy is having healthy habits. Check out these healthy hacks to start your day strong!

Make sure to always follow your doctor’s advice to ensure a speedy recovery and prevent complications from arising. Recovery may be painful and difficult, but keep in mind that bones heal stronger than before.
It is important for adults to consume a healthy mix of daily vitamins to keep their bones stable and strong. We recommend this Vitamin D3 supplement.
Do you have any other questions about a spiral fracture? Let us know in the comments section below! 
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Editor’s Note: This post was originally published on May 7, 2019, and has been updated for quality and relevancy.

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