Oh my God, imagine if you were playing soccer or going down a flight of stairs and suddenly your leg twisted in a strange way, causing unbearable pain and making it impossible to move your arm or leg! If so, you may have suffered from what is called a "spiral fracture." This is a fairly serious type of fracture. So today, let's talk about it in detail, as if you were telling a friend.
What is this spiral fracture?
Simply put, a spiral fracture is a fracture in your body that occurs when a bone is broken by a twisting force . It's like a corkscrew opening a cork. The fracture spreads along the bone in a spiral, or circle. These are often called `` complete fractures`` . This means the bone is completely broken in two.
To understand this better, think of it this way: When you squeeze a wet cloth, it twists in the middle, right? That's how a fracture like this happens when a bone is subjected to a twisting force.
What kind of bones can this happen to?
Spiral fractures usually affect the long bones in our body. Here are a few examples:
- Femur (thigh bone)
- Shin bone (`Tibia`)
- The other small bone outside the shin bone (`Fibula`)
- A bone in the ankle area (`Talus`)
- The bone from our shoulder to our elbow (`Humerus`)
- Bones in the forearm (`Radius` and `Ulna`)
- Small bones in the fingers and toes (`Phalanges` and `Metacarpals`)
When a fracture occurs like this, surgery is often required. The healing time varies depending on the type of bone broken and the cause. However, it usually takes several months for complete healing.
What is the difference between a spiral fracture and a 'greenstick' fracture?
These are both types of fractures, but they have different characteristics. To a doctor, these names tell you how the bone is broken, where it is, and how it looks inside the body.
- A spiral fracture is a break in the bone that forms a spiral staircase. This happens when a bone is subjected to a large twisting force from falls, accidents, or sports injuries. Think of it like someone grabbing your leg and twisting it while you're playing rugby.
- A ` `Greenstick'' fracture is when the bone bends and has a small crack in it, but it doesn't break completely in two. Have you ever tried to break a raw, that is, soft, stick with your hands? It doesn't break cleanly in two like a dry stick, does it? That's how it is. These ``Greenstick'' fractures are most common in young children.
So, no matter what you call it, the most important thing is to see a doctor as soon as you get injured and get it checked out.
What is the connection between this and the 'Toddler Fracture' that occurs in young children?
A 'Toddler Fracture' is actually a subtype of a 'Spiral Fracture'. It usually occurs in children under the age of three. Like other spiral fractures, it is caused by a twisting force, but it most commonly affects the shin bone (the 'Tibia') . Sometimes this can happen when a child trips and falls while walking or running.
How common are these spiral fractures?
Spiral fractures are actually not that common. They are often caused by serious accidents and injuries, so they are less common than other types of fractures.
Who is more likely to have these types of fractures?
Anyone can break a bone, and spiral fractures can happen to anyone. These are often caused by accidents. However, if you fall frequently, you are more likely to have this type of fracture. Also, people with osteoporosis are at higher risk of all types of fractures, including spiral fractures.
What are the symptoms of a spiral fracture?
This type of fracture usually shows the following symptoms:
- Severe pain
- A swelling
- Tenderness when touched
- Inability to move a part of the body that can normally be moved
- Bruising or skin discoloration
- A deformed appearance or a lump that is not normal is visible in that area.
What are 'Open' and 'Closed' breaks?
Your doctor will classify your fracture as 'open' or 'closed'.
- In an open fracture , your bone breaks through the skin. These take longer to heal, and there is a higher risk of infections and other complications.
- In a closed fracture , the bone breaks but does not break through the skin. This is still serious, but the risk of complications is lower than an open fracture.
What is a 'displaced' fracture?
'Displaced' or 'non-displaced' are terms your doctor will use to describe your fracture.
- A displaced fracture is when the broken pieces of bone are displaced, leaving a gap around the fracture.
- In a non-displaced fracture, the bone is still broken, but the pieces have not moved too far out of alignment.
Displaced fractures often require surgery.
What causes these spiral fractures?
Any type of impact that causes a bone to twist can cause this type of fracture. They usually happen when your arm, leg, or body is suddenly pulled out of its normal position. Some of the most common causes are:
- Falls (e.g., falling down stairs, from a height)
- Vehicle accidents
- Sports injuries (e.g., football, rugby, basketball)
- Workplace accidents
Imagine if someone slipped and hit their hand on the ground and twisted their body to the other side, a bone in their hand could break like this.
How does a doctor accurately diagnose a spiral fracture?
A doctor will first do a physical exam on you. Then, they will order several imaging tests .
What tests are being done for this?
After the physical examination, one or more of these tests may be done:
- X-ray: An X-ray can show exactly if there is a fracture, whether it is spiral or another type, and how much damage is done.
- Magnetic resonance imaging (MRI): Your doctor may order an MRI scan. This can give a complete picture of the damage to the bones and the surrounding tissues. This is especially important to see if there is damage to the muscles, connective tissue, and organs.
- CT scan: If you need to have surgery, your doctor or surgeon will need to know exactly how much damage has been done to your bones. A CT scan can take a more detailed picture of your bones and surrounding tissue than an X-ray.
How is a spiral fracture treated?
The treatment for your spiral fracture depends on the severity of the original fracture and the type of bone that was broken. Broken bones need to heal and come back together. Depending on how damaged they are and what caused the fracture, your doctor may use different treatments.
Immobilization
If your fracture is not too severe, meaning the bone fragments are not too far apart (`non-displaced`), you may be able to recover with just a splint or cast . A splint usually lasts for about three to five weeks. A cast may last longer, usually six to eight weeks. However, you will need to have another X-ray to make sure the bone is healing properly.
Bone reduction without surgery (Closed Reduction)
For more serious fractures, a procedure called a 'closed reduction' is used to realign the bones. This is not surgery. The doctor holds and pulls the broken bone pieces back into place from the outside. During this procedure, you will be given one of the following to help reduce pain:
- A local anesthetic will numb only the area around the fracture.
- Sedatives to relax the whole body.
- General anesthesia will put you to sleep throughout the entire procedure.
After this 'closed reduction', the doctor will put a splint or plaster on you.
Surgery for spiral fractures
For very severe fractures, surgery is required. The surgeon will re-set your bones and fix them in place, so that they can heal together. Most often, this is done through an internal fixation . This means that the surgeon will insert metal pieces into your bone and hold it in place until it heals. There are several types of internal fixation:
- Rods: A rod that is inserted through the bone, from top to bottom.
- Plates and screws: Metal plates are used to hold the bone fragments together.
- Pins and wires: Pins and wires are used to hold smaller bone fragments together than other fixation devices. They are usually used in conjunction with rods or plates.
Some people live with these metal pieces in their bodies. Some people have to have surgery again to remove them.
External Fixation
You may also be able to have an external fixation . The surgeon will insert screws or pins into your broken bone on either side of your body and attach them to a support or brace on the outside of your body. This is usually a temporary procedure. It is done to stabilize the fracture and give it time to heal before an internal fixation is performed.
Bone Grafting
If your spiral fracture is displaced in many places, or if the bone is not healing properly, you may need to have a bone graft . The surgeon will insert extra bone tissue and reattach the broken bone. Then, usually with an internal fixation, the pieces are held together until the bone grows back. The tissue for this bone graft can be taken from different places:
- From somewhere else on your own body - most often on the top of your hip bone.
- From another donor (`external donor`).
- An artificial replacement piece.
Surgery for spiral fractures is often an outpatient procedure . This means that depending on the fracture, you should be able to go home the same day. However, if you have surgery on a larger bone, such as your femur or tibia, you may need to stay in the hospital for a day or two.
After surgery, the broken bone is immobilized. You may need to wear a brace, splint, or cast before you can put weight on it again or use it as you did before the fracture.
What medicine is given for this?
Over-the-counter painkillers like aspirin or ibuprofen (NSAIDs ) can cause bleeding and other complications after surgery. Therefore, your surgeon will tell you about medications you can take to reduce pain after surgery.
What are the possible complications of treating a spiral fracture?
Surgery for a spiral fracture can cause complications such as:
- Acute Compartment Syndrome (ACS): Pressure in the muscles increases, blood flow to the tissues is cut off, and permanent muscle and nerve damage can occur.
- Malunion: Broken bones that do not fit together properly when they heal.
- Nonunion: The bones do not grow back together completely and properly.
- Bone infection (Osteomyelitis): If you have an open fracture (where the bone breaks through the skin), you are at higher risk of developing a bacterial infection.
- Other internal injuries: Fractures can damage the muscles, nerves, blood vessels, tendons, and ligaments around the injured area.
Also, NSAID medications can cause side effects:
- Bleeding
- Ulcers
- Stomach pain
- Intestinal complications
How soon will I feel better after treatment?
It may take several weeks for your symptoms to subside. Depending on the type of surgery you had to repair your spiral fracture and the broken bone, you should be able to gradually move your body again within a few weeks.
Important: If you have severe pain that is unbearable and does not go away, call your doctor immediately.
How can we protect ourselves from fractures like this?
Follow these safety tips to reduce the risk of injury:
- Always wear your seat belt when driving.
- Wear appropriate safety equipment for every activity and sport.
- Keep your home and workplace free of unnecessary items that could trip you or others.
- Always use proper tools or equipment when lifting things from the house. Never climb on chairs, tables, or counters.
- Follow a diet and exercise plan that helps maintain your bone health .
- If you are over 50, or if someone in your family has osteoporosis , talk to your doctor about a bone density test.
Can a spiral fracture be prevented?
Spiral fractures are most often caused by falls, accidents, or sports injuries, so there is little that can be done to prevent them. However, following the safety measures mentioned above can help reduce the risk somewhat.
What to expect if you have a spiral fracture?
If you have a spiral fracture, you can expect to make a full recovery.
You will need physical therapy to regain strength and range of motion in the injured body part.
How long will it take for this to heal?
The time it takes for you to recover depends on the severity of your fracture and the treatment you need. Most people take several months to recover from a spiral fracture.
There are many other factors that can affect how long it will take for your body to heal. Talk to your doctor or surgeon about a time frame that is right for your situation.
Can't go to work or school?
Your specific injuries and broken bones will determine how long you will be away from work, school, and other activities.
While you are recovering, talk to your surgeon or doctor before resuming any physical activity.
Finally about a spiral fracture...
The outlook for most spiral fractures is good. Even if you have surgery, you should make a full recovery. Depending on the severity of your fracture, you may need to avoid certain activities after you recover. Talk to your doctor or surgeon about the best ways to prevent future injuries and fractures.
When should we go to the hospital urgently?
If you think you have a spiral fracture – or any other fracture – you should see a doctor right away. Go to the emergency room if you have any of the following symptoms:
- Severe pain.
- Inability to move a part of the body that can normally be moved.
- If a part of the body has changed significantly in appearance or is protruding out of its normal position.
- If your bones are visible through your skin.
- Swelling.
- If new bruises are visible along with these other symptoms.
If you have a serious injury (trauma), go to the emergency room immediately.
What questions should you ask the doctor?
When you see a doctor, you can ask questions like these:
- Which bone is broken?
- Do I have a spiral fracture or another type of fracture?
- Do I need surgery?
- How long will it take to recover?
- When can I start physical activity again?
Spiral fractures are a scary injury, but your doctor and surgeon will get you back on your feet as quickly as possible. Don't rush your recovery. Take it one step at a time, and give yourself time to heal. Talk to your doctor about ways to keep your bones strong and healthy, and get regular bone density tests if you're over 50 or have a family history of osteoporosis.
Summary (Take-Home Message)
A spiral fracture is a fracture in which a bone is broken by a twisting force. It moves along the bone like a corkscrew. These are often caused by falls and sports accidents. Symptoms can include severe pain, swelling, and inability to move. Treatment includes casting and surgery. The most important thing is to seek medical advice immediately if you have an injury like this. With proper treatment and rest, you can make a full recovery. So don't panic, but don't delay either!
` Fractures, spiral fractures, torsion fractures, bone surgeries, bone healing, accidents, sports injuries
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