Spiral Fracture

What is a spiral fracture?

Spiral fractures are a type of broken bone. They happen when one of your bones is broken with a twisting motion. They create a fracture line that wraps around your bone and looks like a corkscrew. You might see spiral fractures referred to as complete fractures. This means the line of the break goes all the way through your bone.

Spiral fractures usually affect long bones in your body. Some of the most common include:

• Femur (thigh).
• Tibia (shin).
• Fibula (calf).
• Talus (ankle).
• Humerus (upper arm).
• Radius and ulna (forearm).
• Phalanges and metacarpals (fingers and hand).

Spiral fractures are almost always caused by falls or other traumas. You might need surgery to repair your bone. How long it takes to recover fully depends on which of your bones are fractured — and what caused the breaks. Most people need a few months to recover from a spiral fracture.

Spiral fractures vs. greenstick fractures

Spiral fractures and greenstick fractures are different types of bone fractures. They are different terms that tell your healthcare provider specific details about how your bones are broken, where they are broken and what they look like inside of your body right now.

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).

Greenstick fractures happen when your bone is bent to the point that it cracks but doesn’t break all the way through. If you’ve ever tried breaking a green, or young, stick with your hands, it cracks but doesn’t break cleanly as a dry twig would. That cracking without snapping completely is the difference between greenstick fractures and complete fractures. Greenstick fractures are more common in kids than adults.

Spiral fractures vs. toddler fractures

Toddler fractures are a type of spiral fracture that usually affects children younger than three. Toddler fractures are caused by the same twisting motions as other spiral fractures, but almost always happen to children’s shin bones (tibia).

No matter which names and terms are applied to your fracture, the most important first step is getting your injury examined by a healthcare provider as soon as possible.

How common are spiral fractures?

Spiral fractures are rare. Because they’re caused by serious accidents and traumas most people don’t experience, spiral fractures are much less common than other types of broken bones.

Who gets spiral fractures?

Spiral fractures — like all bone fractures — can affect anyone. This is especially true because they’re caused by accidents or traumas. If you’re at risk for falls, you might be more likely to experience a spiral fracture. People with osteoporosis have an increased risk for all types of broken bones, including spiral fractures.

What are the symptoms of a spiral fracture?

Symptoms of a spiral fracture include:

• Pain.
• Swelling.
• Tenderness.
• Inability to move a part of your body that you usually can.
• Bruising or discoloration.
• A deformity or bump that’s not usually on your body.

Open vs. closed fractures

Your healthcare provider will classify your fracture as either open or closed. If you have an open fracture, your bone breaks through your skin. Open fractures usually take longer to heal and have an increased risk of infections and other complications. Closed fractures are still serious, but your bone doesn’t push through your skin.

Displaced spiral fractures

Displaced or non-displaced are more terms your healthcare provider will use to describe your fracture. A displaced fracture means the pieces of your bone moved so much that a gap formed around the fracture. Non-displaced fractures are still broken bones, but the pieces weren’t moved far enough to be out of alignment during the break. Displaced fractures are much more likely to require surgery to repair.

What causes spiral fractures?

Any impact to your bones that twists them can cause spiral fractures. They’re usually caused by something suddenly jerking one of your limbs or your body away from their usual position. Some of the most common causes include:

• Falls.
• Car accidents.
• Sports injuries.
• Workplace accidents.

How are spiral fractures diagnosed?

Your healthcare provider will diagnose a spiral fracture with a physical exam and imaging tests.

What tests are done to diagnose a spiral fracture?

After a physical exam, you’ll likely need at least one of a few imaging tests:

• X-rays: An X-ray will confirm any spiral or other fractures and show how damaged your bones are.
• Magnetic resonance imaging (MRI): Your healthcare provider might use an MRI to get a complete picture of the damage to your bones and the area around them. This’ll show them tissue around your bones, too. This is especially important to determine if your muscles, connective tissue and organs were injured.
• CT scan: If you need surgery, your healthcare provider or surgeon needs to know exactly how damaged your bones are. A CT scan will give them a more detailed picture of your bones and the surrounding tissue than an X-ray.

How are spiral fractures treated?

How your spiral fracture is treated depends on the severity of your original break and which bone is broken. Your broken bones need to heal back together. Depending on how damaged they are and what caused them to break, there are a few treatments your healthcare provider might use.

Immobilization

If your break is mild and your bones didn’t move far out of place (if it’s non-displaced), you might only need a splint or cast. Splinting usually lasts for three to five weeks. If you need a cast, it will likely be for longer, typically six to eight weeks. In both cases, you’ll likely need follow-up X-rays to make sure your bones are healing correctly.

Closed reduction

More severe breaks require a closed reduction to set (realign) your bones. During this nonsurgical procedure, your healthcare provider will physically push and pull your body on the outside to line up your broken bones on the inside. To prevent you from feeling pain during the procedure, you’ll receive one of the following:

• Local anesthetic to numb the area around your fracture.
• Sedatives to relax your whole body.
• General anesthesia to make you sleep through the procedure.

After the closed reduction, your healthcare provider will put you in a splint or cast.

Spiral fracture surgery

Internal fixation

The most severe fractures require surgery. Your surgeon will realign (set) your bones to their correct position and then secure them in place so they can heal and grow back together. They usually perform what’s called an internal fixation, which means your surgeon inserts pieces of metal into your bone to hold it in place while it heals. Internal fixation techniques include:

• Rods: A rod inserted through the center of your bone that runs from top to bottom.
• Plates and screws: Metal plates screwed into your bone to hold the pieces together in place.
• Pins and wires: Pins and wires hold pieces of bone in place that are too small for other fasteners. They’ll typically be used at the same time as either rods or plates.

Some people live with these pieces inserted in them forever. You might need follow-up surgeries to remove them.

External fixation

You might need an external fixation. Your surgeon will put screws or pins in your bone on either side of your fracture inside your body, then connect them to a brace or bracket around the bone outside of your body. This is usually a temporary way to stabilize your fracture and give it time to begin healing before you have an internal fixation.

Bone grafting

You might need bone grafting if your spiral fracture is severely displaced or if your bone isn’t healing back together as well as it should. Your surgeon will insert additional bone tissue to rejoin your fractured bone. After that, they’ll usually perform an internal fixation to hold the pieces together while your bone regrows. Bone grafts can come from a few sources:

• Internally from somewhere else in your body — usually the top of your hip bone.
• An external donor.
• An artificial replacement piece.

Spiral fracture surgeries are usually outpatient procedures, and you should be able to go home the same day depending on the bone that was fractured. If you need surgery on a larger bone like your femur (thigh) or tibia (shin), you’ll probably need to stay in the hospital for a day or two after your surgery.

After your surgery, the part of your body with the fractured bone in it will be immobilized. You’ll need some combination of a brace, splint or cast before you can start putting any weight on it again or using it like you did before your fracture.

What medications are used to treat spiral fractures?

Over-the-counter NSAIDs like aspirin or ibuprofen can lead to bleeding and other complications after a surgery. Your surgeon will talk to you about the medications you can take to reduce pain after your surgery.

Complications of spiral fracture treatment

Spiral fracture surgery complications include:

• Acute compartment syndrome (ACS): A build-up of pressure in your muscles may stop blood from getting to tissue, which can cause permanent muscle and nerve damage.
• Malunion: This happens when your broken bones don't line up correctly while they heal.
• Nonunion: Your bones may not grow back together fully or at all.
• Bone infection (osteomyelitis): If you have an open fracture (the bone breaks through your skin), you have an increased risk of bacterial infection.
• Other internal damage: Fractures can damage the area around the injury, including your muscles, nerves, blood vessels, tendons and ligaments.

Side effects of NSAIDs include:

• Bleeding.
• Ulcers.
• Stomach pain.
• Bowel complications.

How soon after treatment will I feel better?

It might take a few weeks for your symptoms to improve. Depending on which type of surgery you had to repair your spiral fracture — and which bones were broken — you should be able to start moving again in a few weeks.

If you experience intense pain that doesn’t get better, contact your healthcare provider right away.

How can I reduce my risk for spiral fractures?

Follow these general safety tips to reduce your risk of an injury:

• Always wear your seatbelt.
• Wear the right protective equipment for all activities and sports.
• Make sure your home and workspace are free from clutter that could trip you or others.
• Always use the proper tools or equipment at home to reach things. Never stand on chairs, tables or countertops.
• Follow a diet and exercise plan that will help you maintain good bone health.
• Talk to your provider about a bone density test if you’re older than 50 or if you have a family history of osteoporosis.

How can I prevent a spiral fracture?

Spiral fractures are usually caused by falls, accidents or sports injuries so there’s not much you can to prevent them.

What can I expect if I have a spiral fracture?

If you have a spiral fracture, you should expect to make a full recovery.

You’ll need physical therapy to regain strength and range of motion in the part of your body that was injured.

How long does it take a spiral fracture to heal?

How long it takes you to heal depends on the severity of your fracture and which treatments you needed. Most people need a few months to recover from a spiral fracture.

There are lots of factors that can affect how long it takes your body to heal. Talk to your healthcare provider or surgeon about a timeline that fits your specific situation.

Will I need to miss work or school?

Your specific injuries and which bones are fractured will impact how long you’ll need to miss work, school and other activities.

Talk to your surgeon or healthcare provider before resuming any physical activities while you’re recovering.

Outlook for a spiral fracture

The outlook for most spiral fractures is positive. Even if you need surgery, you should make a full recovery. Depending on the severity of your fracture, you might need to avoid certain activities even after you’ve recovered. Talk to your healthcare provider or surgeon about the best ways to prevent future injuries and fractures.

When should I go to the emergency room?

If you think you have a spiral fracture — or any other broken bone — you need to see a healthcare provider as soon as possible. Go to the emergency room if you experience any of the following:

• Intense pain.
• You can’t move a part of your body that you usually can.
• A part of your body is noticeably different looking or out of its usual place.
• You can see your bone through your skin.
• Swelling.
• New bruising that appears at the same time as any of these other symptoms.

Go to the emergency room right away if you’ve experienced a trauma.

What questions should I ask my doctor?

• Which bones are fractured?
• Do I have a spiral fracture or another type of break?
• Will I need surgery?
• How long will it take to recover?
• When can I resume physical activities?

A note from Cleveland Clinic

Spiral fractures are scary-sounding injuries, but your healthcare provider and surgeon will get you back on your feet as possible. Don’t rush your recovery. Take each step as it comes, and give yourself time to heal. Make sure you talk to your healthcare provider about how you can keep your bones strong and healthy, and get regular bone density screenings if you’re older than 50 or have a family history of osteoporosis.