Due to direct and indirect impact on the limbs, a person can be seriously injured. Such damage in medicine is called a helical fracture in a spiral, because it looks like a screw. Direct injury can be obtained with a precise impact on the lower leg, for example, after a heavy load is dropped on the leg or as a result of persistent pressure. Indirect injury people receive as a result of indirect exposure. This can be a jump from a height on an outstretched leg or a sharp turn when the foot is fixed in a certain position. You can get similar injuries while skating.
Fractured tibia
With a helical fracture of the lower leg, in most cases, the injury extends to both of its bones. The fibula can be fractured by direct impact, while the tibia can be fractured by indirect stress. With such a fracture, displacement of the bones is almost never observed due tothe fibula, which holds all the broken parts of the bones in place. A screw fracture occurs due to twisting or bending of the lower leg when the foot is stationary. With such damage, in most cases, there is a violation of the integrity of the soft tissues. A screw fracture of bones is always complex. So, if the lower part of one of them is injured, then the second bone always suffers in the upper section.
Oblique or spiral fracture
In the case of indirect injury, when the lower leg is twisted or compressed, and the foot is fixed, an oblique or spiral fracture occurs. Along with this, a fracture of the diaphysis of the fibula occurs. It may also happen that the broken parts of the bones are displaced, then there is a high probability that the integrity of the interosseous membrane will be violated. How does a spiral fracture manifest?
Symptomatics
There are two bones in the lower leg area - the tibia and the fibula. With a screw fracture of each of them, the patient feels characteristic symptoms. For example, if the fibula is broken, the person will experience mild pain, and a slight swelling will form on the lower limb. However, such an injury is difficult to diagnose due to mild symptoms.
As for the tibia, the most pronounced symptoms are observed with a helical fracture with displacement:
- hematoma;
- severe pain;
- pronounced swelling forms at the fracture site;
- shin deformity;
- movement in the ankle or knee joint will be impossible due to severe pain.
In certain cases, the sharp edge of a broken bone rests on soft tissue. It can be felt or seen visually.
In childhood, these bones are flexible, unlike adults, so with such an injury, displacement is usually not observed, because a piece of bone is held by the periosteum. In addition to a spiral fracture of the tibia, this kind of injury can occur on the arm.
Broken arm
This upper limb injury can occur with or without displacement. The main cause of a fracture of any arm bone is a simultaneous intense mechanical impact on it, for example, a fall with an emphasis on the arm, a blow against a hard object or a blow to the arm with such an object, a bite from predatory animals.
Diagnosis
Any diagnostic measures for a helical fracture begin with an examination of the patient. It is very important that the person describes the situation in which the injury occurred as accurately as possible. As a rule, only an experienced specialist can diagnose a spiral fracture.
First of all, the doctor checks the movements of the injured limb. To find out if the bone is broken, the patient is asked to move their leg or arm. However, such a procedure can only be carried out by a doctor, since incorrect and rough independent movements can provoke even greater damage to blood vessels and tissues through sharp bone parts.
Next, when diagnosing a spiral fracture, the doctor checkscrepitus, which is a characteristic sound that can be heard when moving the injured limb. It resembles a specific crunch, as if bubbles are bursting. To determine this characteristic symptom, it is necessary to press on the site of the alleged helical fracture. In addition, to check for damage, the doctor presses on the site of the fracture itself or on the heel. If a person feels severe pain, this means that the bone is broken.
X-ray limbs
After the physical examination, an x-ray of the limb should be taken. It will reliably confirm the diagnosis or help to exclude a helical fracture of the bone. As a rule, the picture is taken in the projection from the front (rear) and from the side. Also, when confirming the diagnosis, the specialist can resort to instrumental diagnostic methods.
First Aid
In order to reduce the risk of complications in the described type of fracture, it is necessary to provide a person with first aid. It is good if the emergency room is nearby, and the patient can be transported there on their own in a private car. But in cases where the hospital is far away, certain measures must be taken before the ambulance arrives.
The first thing to do when you get a spiral fracture is to take pain medication. After that, you should immobilize the limb as much as possible using a splint or improvised means. When applying a splint, it is extremely important to proceed carefully so as not to harm the victim.
If the fracture is open, it is necessaryclean the wound surface from dirt and foreign bodies, and then apply a sterile dressing on it. If a person is bleeding heavily, a tourniquet may be needed. If the fracture is serious, the patient may go into shock, and in such a case, the victim must be brought to his senses, that is, anti-shock measures should be taken.
After providing first aid in a trauma center near the house, a person must be taken to a hospital where doctors will make a final diagnosis and determine the type of treatment: conservative or surgical.
Treatment
The easiest and fastest way to heal a fracture of the fibula of the lower leg and bones of the hand. Such injuries in most cases occur without displacement. Therefore, doctors apply a cast and leave a bandage for a maximum of 2 weeks. During this time, the bone is restored almost completely without any complications or negative consequences. However, this applies to fractures of mild severity, without displacement of the bones. For complex fractures, skeletal traction is used in most cases. Serious and long-term treatment requires fractures of the fibula and tibia at the same time, or if only the tibia is broken.
For the treatment of a helical fracture with displacement, a plaster splint is applied to the patient for 1.5 months. If the tibia is damaged, and its fragments are displaced, but they can be easily fixed in the right place, doctors carry outclosed reposition, after which the injured limb is fixed.
Ilizarov Apparatus
The Ilizarov apparatus on the arm is often used. Usually it is established for a rather long period, the duration of which is determined by the doctor. The device is attached using pins that are passed through holes in the bone. The patient is under anesthesia. The needles are crossed at an angle of 90 degrees and fixed on the ring. The required length is marked with nuts. Subsequently, the doctor adjusts the desired length. With the help of the Ilizarov apparatus, parts of the bone fit tightly to each other. This device does not allow them to diverge, as it fixes the fragments.
Skeletal traction for fracture
This method of therapy involves the fixation of bones using a splint, weights and spokes. As a result, the muscles relax, the fracture area is immobilized, and the bones grow together. The technique allows to reduce the duration of treatment and rehabilitation. The doctor can observe the process and, if necessary, change the design. The term of imposition is not less than 1.5 months. Skeletal traction is not prescribed in childhood and old age. The main contraindication is also the process of inflammation in the area of damage.
Before skeletal traction, local anesthesia is performed. The procedure is performed by the surgeon, taking into account the requirements of the sterility of the instruments used and the premises. Kirchner metal spokes are used. With the help of a drill, the doctor passes the needle through the holes made in the bone tissue and fastens it with special clamps.bones. Outside, to prevent infection, the spokes are covered with sterile wipes. The tension of the spokes occurs through the bracket installed on it.
An important aspect of the efficiency of this technology is the calculation of the used loads. So, during the calculation of the load on the limb in case of traumatization of the femur, the mass of the leg is used, which is 15% of the body mass. In case of fractures of the lower leg, this weight is divided in half.
Rehab
It takes about four months to fully recover from a helical leg fracture. With comminuted fractures, the presence of complications or combined injuries, the rehabilitation period can take even longer - up to six months. In order for a person to return all the abilities of bones after damage, certain procedures are used in medicine, which include:
- rubbing and therapeutic massage;
- resumption of limb movements in the early stages of the rehabilitation period;
- physiotherapy exercises;
- physiotherapy necessary for the prevention of the dystrophic process and the emancipation of movements;
- limit physical activity;
- dieting.
This kind of injury is rather difficult to treat, and therefore the rehabilitation period after it is longer than after simpler injuries of the limbs.
We have given a detailed description of the spiral fracture.
