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A spiral fracture is when a bone breaks in a helix pattern under a twisting or torsion force. These types of fractures often produce jagged edges that can make it difficult to reduce, or realign, the bone for immobilized healing. When this is the case, the best treatment for this torsion fracture is surgery to insert pins or rods to stabilize the bones. If the spiral fracture is fairly clean and the bones can be easily reduced, then immobilization can be accomplished using a cast. Typical recovery time for this type of twisting fracture is four to six weeks.
It is easy to picture a spiral fracture if you take a stick and break it by applying a twisting force. The broken ends of the stick are angled and uneven. It can be difficult to realign the two broken ends to make the stick whole again. This is the situation with most spiral fractures in a bone. Typically, the fractured bone ends are jagged and uneven, and some bone fragments may even break completely free.
In this extreme case, two problems arise in the treatment of a spiral fracture. First, it can be very difficult to reduce the uneven ends of the bone so that the bone can be immobilized. Second, the bone fragments may lacerate blood vessels and muscles. This is especially true if the bone was not properly immobilized before medical treatment was received. These problems make surgery the best option when a spiral fracture creates jagged and uneven bone ends.
Surgery to restore broken bones is called open reduction and requires general anesthesia. During open reduction, the torsion fracture in the bone is revealed through an incision in the skin. The area surrounding the break will be inspected for blood vessel or muscle tears and, if necessary, these issues will be repaired. The bone is then realigned as much as possible; secured using a pin, screws or a rod; and finally the incision is sutured closed. The bone will be immobilized and protected during healing using a cast or splint.
Occasionally, especially in children, a spiral fracture will be relatively clean and a closed reduction, or realigning of the fractured bone without surgery, can be performed. Closed reduction of a twisting fracture is typically done with local anesthesia, but general anesthesia may also be used. In the case of a clean twisting fracture, the break is reduced and then immobilized with a cast or splint. Most spiral fractures, whether treated with open or closed reduction, take four to six weeks to heal.