What is a spiral fracture? Causes and treatment (2022)

A spiral fracture is a bone fracture that occurs when a long bone is broken by a twisting force.

It usually takes a combination of surgery, rest, and physical therapy to recover from spiral fractures.

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A spiral fracture happens when a long bone is torn in half by a twisting force or impact.

The long bones are the bones of the body that are longer than they are wide. Most spiral fractures involve the long bones of the legs, such as the femur, tibia, and fibula.

The injury can also involve the long bones of the arms, including the humerus, ulna, and radius.

Spiral fractures are usually serious injuries and carry the risk of complications.

When long bones are broken on an angle, they often separate into two parts that do not align and have rough, uneven edges. This fracture can make it difficult to put the bone back together.

Spiral fractures are sometimes called torsion or twisting fractures.

Anything that puts a lot of twisting stress or force on a long bone can cause a spiral fracture. But a few specific motions, activities, and circumstances tend to be associated with the injury.

Causes of spiral fractures include:

  • Skiing or snowboarding injuries, when the leg is twisted by being stuck in a ski or snowboarding boot while the rest of the leg continues to move.
  • Soccer injuries, especially when two players run into one another and become entangled or twisted.
  • American football injuries, especially when one player runs into another, one player is held or restrained by another, or a player twists to get free.
  • Wrestling injuries to the legs or arms caused by twists.
  • Motor vehicle and motorcycle accidents.
  • Bicycle accidents, typically those involving a motor vehicle as well.
  • Falling after trying to compensate for a loss in balance by putting out an arm or quickly repositioning the leg.
  • Child abuse, if a child’s arm or leg has been jerked aggressively.
  • Falling down the stairs or a slope with fixed obstacles, such as rocks or trees that can twist an arm or leg away from the rest of the body.
  • Physical violence, when a person’s arm or leg has been twisted forcibly.
  • Machinery injuries that involve someone’s limbs.
(Video) What is a spiral fracture?

Spiral fractures can be extremely painful. Other symptoms commonly associated with the injury include:

  • fainting or losing consciousness
  • inability to put weight on the affected bone
  • loss of feeling and control in the lower leg or arm, especially in the feet and hands
  • bone tenting, where the fractured bone is ready to break through the skin
  • inability to straighten or fully extend the leg or arm
  • signs of bruising
  • inflammation or redness and swelling
  • loss of pulse in the ankle or wrist

A doctor will usually begin by examining the injury, potentially trying to straighten or bend the affected bone. They will also ask questions about when and how the injury happened and how it has been treated so far.

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(Video) What is Spiral Fracture? Spiral Fracture Symptoms, Causes, Treatment, X-ray

Other tests used to diagnosis spiral fractures include:

  • X-rays
  • CT scans
  • radiographs
  • blood tests

Without proper imaging, a spiral fracture can be mistaken for another type of fracture, such as an oblique fracture.

On scans and X-rays, a spiral fracture is identifiable because it looks like a corkscrew.

Treatment for a spiral fracture depends on the severity of the breakage and damage to the surrounding tissues and blood vessels.

Immediately after the injury takes place, it is important to make sure no weight is put on the fracture. If possible, it should be splinted to prevent further damage.

The affected limb should be elevated to heart level and iced to reduce blood flow and limit inflammation. Ice should be applied for no longer than 10 minutes at a time.

Acetaminophen is the only over-the-counter medication recommended during initial treatment for a fracture. Anti-inflammatory medications weaken the blood’s ability to clot and may make internal bleeding worse.

A person should not eat or drink anything immediately after the fracture, as surgery may be required.

All fractures require immediate medical care. Calling 911 or an emergency hotline to request an ambulance may be the best way to get to a hospital without further injury.

Surgery

Most spiral fractures require surgery and general anesthesia. Less severe cases, where the bone is not fully separated, may be operated on using local anesthesia.

(Video) Spiral fracture -what is a spiral fracture? I spiral fractures occurs due to torsion force I

If the two ends of the bone are separated then an open reduction surgery will be necessary.

For this procedure, surgeons will usually cut the skin to expose the fracture. They will then examine the entire area, looking for stray pieces of bone, broken blood vessels, and tissue damage before realigning or reducing the broken parts of the bone.

If necessary, the bone is then reinforced using pins, screws, or rods to ensure the bone stays aligned while healing. If the surgery involves reinforcement, it is called open reduction with internal fixation surgery.

If the bone is not separated, a doctor may perform closed reduction surgery. Surgeons will guide the bone into proper alignment from the outside, manipulating the bone through the skin.

Post-surgical treatment

After surgery, or with clean breaks, a splint is frequently used to reinforce the proper positioning of the bone ends. A splint can be easily adjusted to allow for inflammation.

For the first few weeks of healing, the broken bones need to be completely immobilized or prevented from moving. Once the swelling has gone down, a cast is usually applied.

A brace may replace the cast after a few weeks, as a brace can be removed for cleaning, physical therapy, and examination. A wheelchair, crutches, or a walker may also be necessary to limit the weight put on the limb.

For the first 48 hours after the splint and cast are applied, the limb should be elevated to heart level. Icing and elevation should be used periodically throughout the day as needed or directed by a doctor.

Medications will be prescribed to help manage pain. A doctor will typically also prescribe antibiotics to prevent infection.

Gradual weight-bearing activities may be appropriate 4 to 6 weeks after the injury. However, for severe cases, it often takes 12 or more weeks before the bone can begin to bear weight. Reinforcing devices like rods and pins are usually removed between 3 and 6 months after surgery.

Even after the cast or brace is removed, most people still need to limit movement in the affected limb. In the case of leg injuries, a walker or crutches may be used for a few weeks or months after casts or braces are removed.

In total, it often takes between 4 and 6 months for a full recovery from a spiral fracture. Severe injuries may take as long as 18 months to heal properly.

If left untreated, a fracture can be life-threatening. Spiral fractures also increase the risk of developing additional health conditions. Complications can also occur during surgery.

Common complications associated with spiral fractures include:

  • compartment syndrome, where blood to the leg is stopped by inflammation or swelling
  • blood vessel and nerve damage
  • muscle damage
  • infection, including osteomyelitis or a chronic infection of the deep bone
  • sepsis, when the immune system begins to damage the tissues after being overstimulated by a severe infection
  • non-union or malunion, when the bone does not heal or heals incorrectly
  • pulmonary emboli, when a blood clot breaks loose and goes into the lungs
(Video) Fractures, Causes, Signs and Symptoms, Diagnosis and Treatment.

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There is no real way to prevent a spiral fracture. Most people experience the injury due to an accident or during sporting activities.

However, there are factors considered to increase the likelihood of bone fractures.

Known risk factors for fractures include:

  • prior history of bone injury
  • bone disease
  • chronic malnutrition
  • age
  • low physical activity level
  • exposure to violence or abuse
  • failure to wear protective gear, such as wrist guards for football, rugby, and snowboarding
  • tobacco smoking
  • nerve injury or disease
  • muscle damage
  • neurological conditions
  • genetic conditions that affect bone formation and stability, such as osteogenesis imperfecta
  • preterm birth
  • osteomyelitis or bone infection
  • vitamin C deficiency (scurvy)
  • vitamin D deficiency (rickets)
  • copper deficiency or Menkes disease, a congenital condition present at birth that impairs copper metabolism
  • alcoholism

Avoiding, preventing, or reducing these factors can, in turn, reduce the risk of a spiral fracture.

FAQs

What would cause a spiral fracture? ›

Spiral fractures happen when a fracture winds around the length of your bone — like a spiral staircase. They can be caused by, falls, accidents and sports injuries when your bones are twisted with great force (like getting tackled in football).

How do they treat a spiral fracture? ›

A spiral fracture is usually treated right away with surgery. After the surgery, a cast may be worn. Most spiral fractures involve the long bones of the legs such as the femur, tibia and fibula, but can also include the long bones of the arm including the humerus, ulna and radius.

Can a spiral fracture heal without surgery? ›

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.

How serious is a spiral fracture? ›

Spiral fractures are usually serious injuries and carry the risk of complications. When long bones are broken on an angle, they often separate into two parts that do not align and have rough, uneven edges. This fracture can make it difficult to put the bone back together.

Can a spiral fracture be accidental? ›

Accidental spiral fractures of the tibia are common in preschool children who fall short distances onto an extended leg, and are often called "toddler's fractures." Spiral fractures in very young children are highly suspicious for abuse since they are the result of forceful twisting or jerking of an extremity.

What is an example of a spiral fracture? ›

Spiral fractures often occur when the body is in motion while one extremity is planted. For example, a spiral fracture of the tibia (the shinbone) can occur in young children when they fall short on an extended leg while jumping. This occurrence is known as "toddler's fracture".

Why is a spiral fracture considered as being suspicious? ›

Spiral fractures arise as a result of a twisting force applied to the bone. For a long time, such fractures were seen as particularly suspicious for abuse because for the twisting force to be applied, violence from another person was seen as the prerequisite.

How long does a 5th metatarsal spiral fracture take to heal? ›

You have sustained a fracture to the mid-shaft of the 5th Metatarsal of your foot. Please see the picture below to understand where this injury is. This normally takes approximately 6 weeks to unite (heal) although pain and swelling can be ongoing for 3-6 months.

What is worse a fracture or a break? ›

Some people assume that fractured bones are more serious than broken bones, while others assume it's the other way around. But the truth is that these terms are used interchangeably, and they have the same meaning to medical professionals.

Is a fracture the same as a break? ›

The words fracture and break mean the same thing. People often confuse a simple fracture with a complex fracture. A simple fracture is a bone that is broken in two pieces while a complex fracture is broken into more than two pieces.

How do you tell if a fracture is healing? ›

4 Signs Your Fracture Is Healing
  1. Pain Decreases. No matter how big or small your fracture is, the one thing they all hold in common is the pain you'll experience due to it. ...
  2. Increased Mobility. ...
  3. Lack of Bruising. ...
  4. Swelling Subsides.
30 Dec 2021

Can you walk on a fractured leg? ›

You usually will not be able to walk on it. If it's a severe fracture, the leg may be an odd shape and the bone may even be poking out of the skin. There may have been a "crack" sound when the leg was broken, and the shock and pain of breaking your leg may cause you to feel faint, dizzy or sick.

What is the difference between a spiral and oblique fracture? ›

Oblique fractures are slanted fractures that occur when a force is applied at any angle other than a right angle to the bone. Spiral fractures are the result of an extreme twisting force being exerted on a bone.

What is a spiral fracture of the 5th metatarsal? ›

A fifth metatarsal fracture is a common injury where the bone connecting your ankle to your little toe breaks. These fractures occur from injury, overuse or high arches. Providers can treat your broken bone with a cast, boot or shoe — or with surgery.

How long does it take for a spiral fracture of the fibula to heal? ›

After an injury, it can take up to 12-16 weeks to make a full recovery. Your doctor will use X-rays to see how well your fracture is healing. They'll also look to see when they can remove the screws, if you have them.

Which fracture is most consistent with physical abuse? ›

Two studies confirmed that anterior fractures were significantly more common in abuse and that lateral fractures were more common in non-abused children.

What is the most common type of injury to a bone? ›

According to the American Academy of Orthopaedic Surgeons (AAOS), the most common causes of bone fractures are trauma, osteoporosis, and overuse.

Why do spiral fractures heal faster? ›

Cancellous bones heal faster than cortical bones (Figure 7). This is due to the fact that there is a large area of bony contact and there are more active bone cells present.

How long does a metacarpal spiral fracture take to heal? ›

Most of the healing happens between three to six weeks but can take several months for your full symptoms to settle completely. In addition, once the fracture has healed you may have a permanent 'bump' where the bone was fractured. This is entirely normal and not the result of poor or the fracture not healing.

How long does it take for a stable fracture to heal? ›

How Long Does a Fracture Take to Heal? Most fractures heal in 6-8 weeks, but this varies tremendously from bone to bone and in each person based on many of the factors discussed above. Hand and wrist fractures often heal in 4-6 weeks whereas a tibia fracture may take 20 weeks or more.

What fracture indicates abuse? ›

Fractures With High Specificity for Abuse

Rib fractures in infants, especially those situated posteromedially, and the classic metaphyseal lesions of long bones, have high specificity for child abuse. Fractures of the scapula, spinous process, and sternum also have high specificity for abuse but are uncommon.

Can you walk on a fractured tibia? ›

Can you still walk with a fractured tibia? In most cases, the answer is no. Walking after a tibia fracture can make your injury worse and may cause further damage to the surrounding muscles, ligaments and skin. Walking on a fractured tibia is also likely to be extremely painful.

Can you walk on a fractured fibula? ›

Because the fibula is not a weight-bearing bone, your doctor might allow you walk as the injury recovers. You also might be advised to use crutches, avoiding weight on the leg, until the bone heals because of the fibula's role in ankle stability.

Do you need a boot for a 5th metatarsal fracture? ›

There are five metatarsal bones in each foot, you have fractured the fifth which is on the outer edge of the foot. This is a common fracture. You will be given a removable boot to wear to support your foot; this should be used for two to six weeks to enable you to walk more comfortably whilst the injury heals.

Do you need a cast for 5th metatarsal fracture? ›

Can a 5th metatarsal fracture heal without a cast? A 5th Metatarsal Fracture is unlikely to heal without a cast or walker boot as the impact and vibration from walking can irritate the fracture site, preventing it from healing.

Can you use a walking boot with metatarsal fracture? ›

You should remain immobilized in a walking boot/post-op shoe until 4 weeks from the initial injury. You are allowed to fully weight bear as tolerated in the walking boot/post-op shoe.

What helps broken bones heal faster? ›

In particular, calcium, vitamin D and protein will be important during the bone healing process, so be sure you're focusing on food sources rich in these nutrients, including dark, leafy greens, broccoli, fish, meat, yogurt, nuts and seeds.

Why do fractures take longer to heal in the elderly? ›

With increasing age, perturbations in bone fracture healing are associated with age-related dysfunction to the bone vascular system and its ability to regenerate in healing. Generally, the vascular perfusion of the skeleton decreases with age [79].

When does a fracture stop hurting? ›

After about a week or two, the worst of the pain will be over. What happens next is that the fractured bone and the soft tissue around it start to heal. This takes a couple of weeks and is called subacute pain. You may still be on pain medication, but it may be a lower dosage or a weaker drug.

What's the most painful bone to break? ›

The Femur is often put at the top of the most painful bones to break. Your Femur is the longest and strongest bone in your body, running from your hip to your knee. Given its importance, it's not surprising that breaking this bone is an incredibly painful experience, especially with the constant weight being put on it.

What type of fracture is considered traumatic? ›

A traumatic fracture occurs when significant or extreme force is applied to a bone. Examples include broken bones caused by impacts from a fall or car accident, and those caused by forceful overextension, such as a twisting injury that may cause an ankle fracture. Traumatic fractures may be nondisplaced or displaced.

Can a fracture heal without a cast? ›

Technically speaking, the answer to the question “can broken bones heal without a cast?” is yes. Assuming conditions are just right, a broken bone can heal without a cast. However, (and very importantly) it doesn't work in all cases. Likewise, a broken bone left to heal without a cast may heal improperly.

How do you know if a fracture is getting worse? ›

Symptoms of a fracture that is not healing normally include tenderness, swelling, and an aching pain that may be felt deep within the affected bone. Often, the bone isn't strong enough to bear weight, and you may not be able to use the affected body part until the bone heals.

What foods are good for broken bones? ›

When you have a fracture, your body needs it to build new bone for the repair. It also helps your body take in and use calcium, another key nutrient for healthy bones. Good sources: Meat, fish, milk, cheese, cottage cheese, yogurt, nuts, seeds, beans, soy products, and fortified cereals.

Why do fractures hurt more at night? ›

During the night, there is a drop in the stress hormone cortisol which has an anti-inflammatory response. There is less inflammation, less healing, so the damage to bone due to the above conditions accelerates in the night, with pain as the side-effect.

What is an example of a spiral fracture? ›

Spiral fractures often occur when the body is in motion while one extremity is planted. For example, a spiral fracture of the tibia (the shinbone) can occur in young children when they fall short on an extended leg while jumping. This occurrence is known as "toddler's fracture".

Why is a spiral fracture considered as being suspicious? ›

Spiral fractures arise as a result of a twisting force applied to the bone. For a long time, such fractures were seen as particularly suspicious for abuse because for the twisting force to be applied, violence from another person was seen as the prerequisite.

How long does a spiral fracture of the femur take to heal? ›

Recovery. Most femoral shaft fractures take 3 to 6 months to completely heal. Some take even longer, especially if the fracture was open or broken into several pieces or if the patient uses tobacco products.

What is the difference between a spiral and oblique fracture? ›

Oblique fractures are slanted fractures that occur when a force is applied at any angle other than a right angle to the bone. Spiral fractures are the result of an extreme twisting force being exerted on a bone.

Why do spiral fractures heal faster? ›

Cancellous bones heal faster than cortical bones (Figure 7). This is due to the fact that there is a large area of bony contact and there are more active bone cells present.

How long does a 5th metatarsal spiral fracture take to heal? ›

You have sustained a fracture to the mid-shaft of the 5th Metatarsal of your foot. Please see the picture below to understand where this injury is. This normally takes approximately 6 weeks to unite (heal) although pain and swelling can be ongoing for 3-6 months.

What is the difference between a bone break and a bone fracture? ›

The terms are actually interchangeable and both refer to a bone that has been shattered, often by excessive force. Your doctor may be more likely to use the term fracture. To be frank, the term fracture is more “professional” sounding. To say break would still be correct but more colloquial.

How long does it take for a spiral fracture of the fibula to heal? ›

After an injury, it can take up to 12-16 weeks to make a full recovery. Your doctor will use X-rays to see how well your fracture is healing. They'll also look to see when they can remove the screws, if you have them.

Can you walk on a fractured leg? ›

You usually will not be able to walk on it. If it's a severe fracture, the leg may be an odd shape and the bone may even be poking out of the skin. There may have been a "crack" sound when the leg was broken, and the shock and pain of breaking your leg may cause you to feel faint, dizzy or sick.

What is a spiral fracture of the 5th metatarsal? ›

A fifth metatarsal fracture is a common injury where the bone connecting your ankle to your little toe breaks. These fractures occur from injury, overuse or high arches. Providers can treat your broken bone with a cast, boot or shoe — or with surgery.

Can you walk with a fractured femur? ›

Can I walk on a broken femur? If you have a broken femur, you won't be able to put weight on your injured leg.

What's the most painful bone to break? ›

The Femur is often put at the top of the most painful bones to break. Your Femur is the longest and strongest bone in your body, running from your hip to your knee. Given its importance, it's not surprising that breaking this bone is an incredibly painful experience, especially with the constant weight being put on it.

How do you tell if a fracture is healing? ›

4 Signs Your Fracture Is Healing
  1. Pain Decreases. No matter how big or small your fracture is, the one thing they all hold in common is the pain you'll experience due to it. ...
  2. Increased Mobility. ...
  3. Lack of Bruising. ...
  4. Swelling Subsides.
30 Dec 2021

Which types of fractures are most difficult to repair? ›

Example: A comminuted fracture is the most difficult to repair due to the bone having fractured into numerous pieces. Multiple bone pieces require more effort to hold them together in the ideal position for healing.

What type of fracture takes the longest to heal? ›

How Long Does a Fracture Take to Heal? Most fractures heal in 6-8 weeks, but this varies tremendously from bone to bone and in each person based on many of the factors discussed above. Hand and wrist fractures often heal in 4-6 weeks whereas a tibia fracture may take 20 weeks or more.

What is worse a fracture or a break? ›

Some people assume that fractured bones are more serious than broken bones, while others assume it's the other way around. But the truth is that these terms are used interchangeably, and they have the same meaning to medical professionals.

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