Due to direct and indirect effects on the limbs, a person can be seriously injured. Such damage in medicine is called a helical spiral fracture, because it looks like a screw. Direct injury can be obtained by accurately acting on the lower leg, for example, after a heavy load falls on the leg or as a result of persistent pressure. People get indirect injuries due to indirect effects. This can be a jump from a height to an extended leg or a sharp turn when the foot is fixed in a certain position. You can get similar injuries while skating.
Shin fracture
With a helical fracture of the lower leg in most cases, the injury extends to both of its bones. The fibula can break as a result of direct exposure, and the tibia due to indirect loading. With such a fracture, bone displacement is almost never observed due to the fibula, which holds all broken parts of the bones in place. A helical fracture occurs due to twisting or bending of the lower leg when the foot is stationary. With such damage, in most cases, a violation of the integrity of the soft tissues is noted. Helical bone fracture 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 trauma, 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 tibia diaphysis 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 helical fracture manifest itself?
Symptomatology
In the lower leg area there are two bones - tibial and fibular. With a screw fracture of each of them, the patient feels characteristic symptoms. For example, if the fibula is broken, a person will feel a slight 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, then with a helical fracture with a shift, the most pronounced symptoms are observed:
- hematoma;
- strong pain;
- severe swelling is formed at the fracture site;
- deformation of the lower leg;
- movements in the ankle or knee joint will be impossible due to severe pain.
In certain cases, the sharp edge of a broken bone abuts against soft tissue. It can be felt or noticed visually.
In childhood, these bones are flexible, unlike adults, therefore, with such an injury, displacement is usually not observed, because a piece of bone is held by the periosteum. In addition to a helical fracture of the tibia, this kind of injury can occur on the arm.
Broken arm
Similar trauma to the upper limb can occur with or without displacement. The main cause of a fracture of any bone in the arm is a simultaneous intense mechanical impact on it, for example, a fall with an emphasis on the arm, a blow to a hard object or a blow to the arm with such an object, a bite of predatory animals.
Diagnostics
Any diagnostic measures for a helical fracture begin with an examination of the patient. It is very important that the person as accurately as possible describes the situation in which the injury occurred. As a rule, a helical fracture can only be diagnosed by an experienced specialist.
First of all, the doctor checks the movements of the damaged limb. To find out if the bone is broken, the patient is asked to move his leg or arm. However, a similar procedure can only be performed by a doctor, since irregular and gross independent movements can provoke even greater damage to blood vessels and tissues through sharp bone parts.
Further, when diagnosing a helical fracture, the doctor checks the crepitus, which is a characteristic sound that can be heard when moving a damaged limb. It resembles a specific crunch, as if bursting bubbles. To determine this characteristic symptom, you must click on the site of the alleged helical fracture. In addition, to check for damage, the doctor presses on the site of the fracture or on the heel. If a person feels severe pain, this means that the bone is broken.
X-ray of limb
After a physical examination, an x-ray of the limb must be taken. It will reliably confirm the diagnosis or help to exclude a screw-shaped bone fracture. Typically, a picture is taken in the projection in front (back) and side. Also, when confirming the diagnosis, a 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. Well, if the emergency room is nearby, and the patient can be transported there on his own 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 receiving a screw-like fracture is to take a pain medication. After this, the limb should be immobilized as much as possible with the help of a tire or improvised means. When applying a tire, it is extremely important to be careful not to harm the injured person.
If the fracture is open, it is necessary to clean the wound surface from contaminants and foreign bodies, and then apply a sterile dressing to it. If a person has severe bleeding, a tourniquet may be required. If the fracture is serious, the patient may experience 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 at the emergency room 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 cure a fracture of the fibula of the lower leg and arm bones. Such injuries in most cases occur without displacement. Therefore, doctors apply plaster 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 mild fractures, without bone displacement. In complex fractures, skeletal traction is used in most cases. Serious and prolonged treatment requires fractures of the tibia and tibia at the same time, or if only the tibia is broken.
For the treatment of a helical fracture with a displacement of the patient by 1.5 months, a plaster cast is applied. If the tibia is damaged and its fragments are displaced, but they can be easily fixed in the right place, doctors carry out a closed reposition, after which the injured limb is fixed.
Ilizarov apparatus
Often used Ilizarov apparatus on the arm. Usually it is set for a rather long period, the duration of which is determined by the doctor. The device is attached using knitting needles that pass through holes in the bone. The patient is under anesthesia. The spokes 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. Using the Ilizarov apparatus, parts of the bone fit tightly together. This device does not allow them to diverge, since it fixes fragments.
Skeletal traction during fracture
This method of therapy involves fixing bones using tires, weights and knitting needles. 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 monitor the process and, if necessary, change the design. The term of application is at least 1.5 months. Skeletal traction in children and the elderly is not prescribed. 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 sterility requirements of the instruments and premises used. 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 with special bone fixators. Outside, to prevent infection, the needles are covered with sterile wipes. The tension of the spokes occurs through the bracket mounted on it.
An important point in the effectiveness of this technology is the calculation of the goods used. So, during the calculation of the load on the limb during trauma to the femur, leg weight is used, which is 15% of body weight. With fractures of the lower leg, this weight is divided in half.
Rehabilitation
It takes about four months to fully recover from a screw-like leg fracture. With comminuted fractures, the presence of complications or combined injuries, the rehabilitation period may 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:
- grinding and therapeutic massage;
- the resumption of limb movements in the early stages of the rehabilitation period;
- physiotherapy;
- physiotherapy, necessary for the prevention of dystrophic process and the liberation of movements;
- limitation of physical activity;
- dieting.
Such an injury is treated quite difficult, therefore, the rehabilitation period after it is longer than after simpler injuries to the limbs.
We gave a detailed description of a helical fracture.