Greenstick Fracture Definition
A greenstick fracture typically occurs in children. Greenstick fractures are incomplete fractures of long bones and are commonly mid-diaphyseal. Forearm bones [radius, ulna] and leg bones are commonly affected.
The fractures typically affect the forearm and lower leg.
Greenstick fracture occurs when the force applied to a bone results in bending of the bone and breaks the bone on convex aspect of the bend but does not extend the break to concave surface. The bones of children are soft and are covered with thick fibrous periosteum of immature bone.
The situation is similar to bending a soft green branch of tree [stick]. If you hold a green branch or stick and bend it, it would bend only till some time. If further force is applied, the stick would break on the convex surface.
Greenstick fracture does occur in similar manner when a bending force acts on the bone, one of the cortex bends whereas other breaks.
Signs and Symptoms of Greenstick Fracture
A greenstick fracture would cause pain at the injured area. The area may be swollen and either red or bruised and there could be a visible deformity. Older child may guard the area. Younger children may present with crying only.
Imaging of Greenstick Fracture
Anteroposterior and lateral xrays of the affected part are standard imaging for a greenstick fracture. The xrays would reveal site and deformity of the fracture.
Greenstic Fracture Treatment
The treatment includes reduction of the fracture, which may include overcorrection [completing of the fracture]. In case the angulation is minimal, correction may not be required.
After reduction, three point molding is done to keep tension on intact periosteal hinge. A long arm cast is applied and kept for a period of four to six weeks.
In infants, angulation up to up to 30 degrees is acceptable. In older children up to 15 degrees of angulation may be acceptable depending on age of the patient.
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