Spiral Fracture Injury: What's Serious?

A spiral fracture is a broken bone pattern that wraps around the bone. This type of fracture results from a twisting force on the bone during an injury. Spiral fractures typically affect long bones (those that are longer than they are wide) found in your arms, legs, hands, and feet. These injuries range in severity and require varying treatments and healing time.

This article discusses spiral fractures—affected bone parts, causes of injury, treatment options, and healing time frames.

Spiral Fracture Bones and Affected Body Parts

Spiral fractures affect the long bones in the body, found in the arms and legs. The way we use our arms and legs—for daily tasks like gripping and walking—puts our long bones at a greater risk for spiral fractures from twisting injuries.

Examples include:

• Humerus (upper arm)
• Radius or ulna (forearm)
• Metacarpals or phalanges (hand and fingers)
• Femur (thigh)
• Tibia or fibula (lower leg)
• Metatarsals or phalanges (feet and toes)

As with any broken bone, spiral fractures range in severity. Fractures can be:

• Closed (simple): Skin over the broken bone is intact
• Open (compound): Broken bone pokes through the skin
• Non-displaced: Broken ends of the bone are still in proper alignment
• Displaced: Broken ends of the bone no longer line up

Causes: Why Spiral Fractures Happen

Spiral fractures most commonly occur from high-energy impact and rotational forces on the bone, such as during sports activities, motor vehicle accidents, workplace accidents, or as a result of a fall.

Spiral fractures often occur when one end of the bone is fixed while the other keeps moving, placing a twisting force on the bone. In the lower extremity, most spiral fractures happen when the foot is planted, but the body continues to move.

Young children often experience accidental spiral fractures in the lower leg after falling on an extended leg. Unfortunately, spiral fractures in children are not always accidental. If a healthcare provider, like a radiologist, observes a spiral fracture on an X-ray, they will look for other signs of abuse.

Spiral Fracture Treatment by Type

Spiral fracture treatment varies based on the severity of your break. Initial treatment involves immobilizing the bone for non-displaced (still aligned) or displaced fractures that can be set (put back into place). Depending on the affected bone, a healthcare provider will use a cast that stays in place and is cut off once the bone has healed, or they'll apply a splint/brace that you can remove to clean the skin beneath the brace.

Spiral fractures that are displaced or compound require surgery. One common surgery involves placing a rod through the long bone that is then screwed to the bone at each end—a procedure called intramedullary nailing.

Fractures that are not stable or have multiple pieces that cannot be held together with a rod are typically treated surgically with plates and screws. Very unstable fractures might need external fixation—temporary immobilization with pins that stick out of the skin and are connected to a bar that holds the bone in place while it is healing.

Are Spiral Fractures Worse Than Other Types of Fractures?

Spiral fractures can be more complicated regarding treatment and healing than other fractures. Spiral fractures create a jagged edge around the bone, while other fractures—such as a transverse or oblique fracture—break in a straight line (also called a clean break).

However, compound (open) or comminuted (broken into several pieces), could be considered worse than a non-displaced spiral fracture. Compound, or comminuted, fractures typically require surgery to realign the bones and come with a higher risk of complications such as infection, fascia swelling, or a severe condition known as compartment syndrome.

Spiral Fracture Healing Timeline

How long it takes to heal a spiral fracture depends on injury severity, whether or not you need surgery and your overall health.

Short- and Long-Term Effects

Broken bones typically heal within six to 12 weeks. However, many factors affect the timeline for bone healing, such as your general health and how well you follow your healthcare provider's instructions. Spiral fractures that damage blood supply to the bone can also delay the healing process.

Although the bone can heal within a couple of weeks, returning to full functioning after a spiral fracture can take much longer. Immobilization often leads to stiffness, decreased range of motion, and weakness.

Physical therapy is helpful for restoring function after a spiral fracture. Treatments include modalities to help decrease pain (such as ice, heat, and electrical stimulation), manual therapy (such as massage and stretching), and exercises to improve range of motion and strength.

For a spiral fracture in your leg, your healthcare provider will likely recommend that you avoid putting weight (no weight-bearing) on the affected leg while the bone is healing. A physical therapist may teach you the proper use of assistive devices, such as a walker or cane, and help you walk normally again once your bone is fully healed.

Summary

Spiral fractures are a type of bone break that wraps around the whole bone. This type of injury occurs when a twisting force is applied to the bone, such as turning the body while a foot is planted on the ground. Spiral fractures range in severity, depending on whether or not the broken ends of the bone are in alignment or if the bone pokes through the skin when the injury occurs.

Spiral fractures are often treated with immobilization (with a cast or splint), but sometimes require surgery. Healing time frames can range from a few weeks to several months.