How would you treat a spiral finger fracture? i read this phrase as part of another q/a -- "a leash or rope injury with torque or rotatory force on a finger will cause a spiral fracture of a metacarpal. a fracture of a phalanx." this is exactly what happ

Assess : Assess rotation, assess angualation, treatment based upon those 2 main criteria rotation needs to be recognized and reduced either splintng or more but often for significant rotation some type of surgery, closed pinning or open reduction internal fixation is needed angulation and displacement can affect tendon gliding and final motion. Spiral fracures often require some type of internal fixation if they are displaced but there can be just one straightforward answer ( after all this is medicine) overall any finger fracture needs treatment based upon these criteria and more if it is late, an osteotomy of the metacarpal can be done as the previous post noted.

As : As the other surgeons here have stated, it is all about timing. If your injury happened within 2 (or perhaps 3) weeks, the rotation can still be corrected. Small deformities may respond to casting or splinting, but there is a risk of the finger healing with some rotation that gets in the way. Most deformities do better with pins because there is more direct control of the position of the bone. The word "reduction" in our field means putting the bone back in place. For injuries that have already healed, i usually give the bone some time to solidify. I like to wait 3 months or more. Then the bone has to be re-broken (osteotomized) to correct the deformity. There is an elegant "step-cut" procedure that works well with few risks. The cure has to be worth the disease. If the finger is only slightly rotated, an osteotomy may not be worthwhile. If it is getting in the way of function, it is better to have it done. Rotation can be difficult to assess. Providers without extensive hand training may see a minor fracture on x-rays and miss the deformity. To check rotation, the fingers have to be brought into a fist (or nearly) and that can be rather painful. I have seen very small fractures cause significant rotation. Likewise, rotation can be difficult to correct because of the different positions of flexion and extension. I strongly recommend and evaluation by a hand surgeon.

If : If this has just happened (like in the last week) you should see a hand surgeon. If your finger already twists when you bend it, it will heal in this position unless reduced. Spiral fractures can often be treated with wires (temporary) after reduction or sometimes with plates and/or screws. See a hand surgeon.