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Greenstick Fracture

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Other Names

  • Greenstick Fracture

Background

  • This page describes greenstick fractures to the Radius and Ulna, however they can occur in other trabecular long bones
  • Represent incomplete fractures of long bones, specifically mid-diaphyseal

History

  • Named after a branch of a young tree that bends but breaks incompletely

Epidemiology

  • Usually seen in children under 10, rarely occur in adults[1]

Pathophysiology

  • Partial thickness fracture where only one side of cortex and periosteum are interrupted
  • Compressive force results in a cortical irregularity on the convex side sparing the concave side

Etiology

  • FOOSH
  • MVC
  • Sports
  • Non-accidental trauma

Associated Injuries


Risk Factors

  • Malnutrition
  • Vitamin D deficiency

Differential Diagnosis


Clinical Features

  • General: Physical Exam Forearm
  • History
    • Fall on outstretched hand or some other form of trauma
  • Physical
    • Pain, swelling, bruising, tenderness along radius or ulna

Evaluation

  • Radiographs[2]
    • Typically a mid-diaphyseal fracture
    • Angulation
    • Cortical breach occurs on only one side of the bone

Classification

  • N/A

Management

Nonoperative

  • Generally non-surgical
  • If angulation is significant, need to perform closed reduction
  • Acceptable angulation is < 30° under age 10, and < 20° age 10 and over
  • Splint: Sugar Tong Splint
  • Cast: Long Arm Cast or Short Arm Cast depending on location
  • Duration approximately 6 weeks

Operative

  • Indications Unknown

Return to Play

  • Immobilization for 6 weeks
  • Some period of rehab after
  • Variable RTP

Complications


See Also


References


  1. Cheng JC, Shen WY. Limb fracture pattern in different pediatric age groups: a study of 3,350 children. J Orthop Trauma. 1993;7(1):15-22.
  2. Noonan KJ, Price CT. Forearm and distal radius fractures in children. J Am Acad Orthop Surg. 1998 May-Jun;6(3):146-56.
Created by:
John Kiel on 30 June 2019 19:53:12
Authors:
Last edited:
31 October 2020 00:19:32
Categories:
Trauma | Pediatrics | Forearm | Upper Extremity | Fractures | Acute