Spiral diaphyseal fractures have a very consistent configuration. They usually begin at the level of the third trochanter antero-medially and exit just proximal to the gastrocnemius muscle origin distally. The angle of the fracture can be long oblique or short, almost transverse.
A slightly more complicated version of the long oblique diaphyseal fracture is sometimes seen when the proximal aspect of the distal fragment is fractured in a second plane to create a cranial butterfly fragment. The implant locations are the same in the repair of this fracture as for the Salter-Harris Type II fracture. Strong implants, such as the Dynamic Condylar Screw plate or Locking Plates are needed.