ALGORITHM Figure 4 Closed Complete Displaced Spiral Fracture of the Middle Third of the Left Femur Fall Accident

( patient hit his left leg and thigh on the ground)

Rotational or torsion force is applied to the thigh bone or femur

Stress or rotational force placed on the thigh bone (femur) exceeds what the bone can normally absorb

Injury to the bone

Disruption in the continuity of the femur particularly in the middle third shaft (Spiral Fracture)

Soft tissue injury Disruption of muscle and blood vessels attached to the ends of the femur Bleeding

Hematoma forms in the medullary canal Bone tissue surrounding the fracture site dies
Inflammatory Process

Sudden Pain Swelling Bone tenderness Ecchymosis Decreased or abnormal motion

Steinmans Pin Insertion Balance Skeletal Traction

EXPLANATION A spiral fracture is a type of bone fracture which is caused by a twisting force. They are also referred to as torsion fractures, in a reference to the forces involved to create a spiral fracture. This is a case of Reynaldo Servino, 10 years old. The patient got his fracture due to a fall accident last February 27, 2013. He hit his left leg and thigh in the ground causing a strong rotational or torsion force which was too strong that the left femur was not able to withstand. This resulted to a break in the continuity of the left thigh bone or femur. The force causes the bone to rotate, resulting to a closed spiral fracture. The fracture disrupted blood vessels in the bone which led to internal bleeding resulting to hematoma and ecchymosis formation. There was also muscle and soft tissue injury activating the inflammatory response of the body. The patient presented with an edematous, painful thigh and he was not able to move hip or the knee. There was impaired physical mobility and bone tenderness. He was admitted in the Philippine Orthopedic Center on February 28, 2013 due to painful, and edematous left thigh. After diagnostic procedures, he was diagnosed to have a closed complete displaced spiral fracture of the middle third femoral shaft. As part of the management, Steinmans pin was inserted in the area of injury and balance skeletal traction was applied.