What is Greenstick Fracture?
Each day, numerous children all around the world get injuries due to various reasons. Luckily, most of the injuries seen in young children are not dangerous and can be treated easily. One of the most common types of injuries that occur mostly in the younger population is Greenstick fracture. This injury can be defined as an incomplete fracture of longer bones. This type of injury is unique and very different from other types of injuries since the bones are only bent in it, not broken. Greenstick fracture happens when a young and soft bone bends and breaks. This type of fracture is most common in the children below the age of 10. Children that are under the age of 10 have soft bones that are easier to be broken and injured. Greenstick fracture is most of the time mid-diaphyseal, which means that it mostly involves the fracture of the lower leg and the forearm.
Greenstick fracture got its name because when it happens, it looks just like when you break a small, “green” branch on a tree. This orthopedic condition has been discovered and described by British-American orthopedist called John Insall. Also, Polish-American orthopedist Michael Slupecki contributed a lot in describing and discovering Greenstick fracture. Even the mild cases of Greenstick fracture need to be immobilized in a cast. A cast that is used in the treatment of Greenstick fracture holds the cracked pieces of bone. It also prevents the bone from breaking once again if a child falls on again on the place where it got injured.
Causes of Greenstick Fracture
The main and only cause of Greenstick fracture is falling down. Children that fall down during playing games outside mostly fall on their leg and their forearm. Arm Greenstick fracture are more common since many children throw out their arms to catch themselves when they fall. Thus, an arm fracture occurs. Theoretically, applying a lot of force on one’s bones can also cause Greenstick fracture.
What is Greenstick Fracture in Children?
As it was said before, Greenstick fracture mostly occurs in a children’s population. Since a child’s bones are more flexible and soft than adult people’s bones, they are more prone to Greenstick fracture than all of the other injuries. Children’s bones are more flexible and softer because there is a high amount of calcium present in them.
In children, Greenstick fracture of the bone most commonly occurs in the forearm and the lower leg.
What is Greenstick Fracture in Adults?
Greenstick fractures are very uncommon in adults. Adults commonly get these below types of fractures when they are injured:
- Open fracture.
- Displaced fracture.
- Closed fracture.
- Comminuted fracture.
- Buckle fracture.
- Metaphyseal fracture.
- Monteggia fracture.
- Galeazzi fracture.
The reason why adults do not get Greenstick fracture after they get injured is their bones contain less calcium and are thus less soft. Adults most of the time get Greenstick fracture of the forearm and the lower leg. However, that happens in exceedingly rare situations.
What is a Buckle Fracture?
Buckle fracture is better known in the medical circles as Torus Fracture. Torus Fracture is defined by the orthopedists as an incomplete fracture of the shaft of a long bone. Buckle Fracture is characterized by bulging of the cortex. Torus Fracture happens when only one side of an injured bone is compressed and it buckles, but does not break at all.
This is also known as an incomplete bone fracture. Buckle or torus fractures occurs when the human bone is compressed. Therefore, torus Fracture is a compression type of injury. The one side of human bone that is getting compressed on crunches down on itself which later on causes the human bone to crush on the other side.
The usual torus fracture symptoms are swelling and pain. Children who get this injury sustain it by dropping on outstretched hand. Buckle Fracture does not occur in the adult population. The bones of grown-ups are less elastic and thus less prone to Torus Fracture. On the other hand, a kid’s bone is able to endure a bit of deforming force. Buckle type of fracture is treated in a way in which it is immobilized for brief time, usually two to four weeks. Buckle Fracture heals faster than injury similar to it -Greenstick fracture. Two treatment options are casting and splinting. The benefit of using a cast as a treatment option for buckle fracture is in that it covers the sufferer very well. The benefit of using a splint as a treatment option for buckle fracture is in that it is more simple treatment and it allows more flexibility. Person who wears a splint is able to remove it at anytime there is need for doing so, like when a person is about to take a bath.
The good news about buckle fractures is that they heal in a fast manner and do not make any long haul problems to the patient.
What is a Fissured Fracture?
Fissured Fracture is a less common name for Stress Fracture a.k.a. Hairline fracture. Stress fracture can be defined as a fracture induced by fatigue. It is caused by repeated stress. Stress fractures or hairline fractures are common in athletes since they are a result of excessive athletic activities such as running and jumping. Hairline fractures can also be defined as overuse injuries. They occur when muscles become weak and unable to absorb any further shock. A fatigued muscle that is unable to absorb shock sends it to a nearby bone. That causes a tiny crack in the bone, which is known as hairline fracture or stress fracture.
Symptoms of Greenstick Fracture
The signs and symptoms of Greenstick fracture greatly depend on the injury’s severity. Mild cases of Greenstick fracture are often misdiagnosed for bruises and sprains. Severe cases of Greenstick fracture usually cause an obvious deformity which is accompanied by swelling and severe pain.
Luckily, most of Greenstick fracture do not cause pain. Usually, Greenstick fracture does not cause any symptoms at first. However, some Greenstick fracture immediately cause swelling in the injured area. Your orthopedist will suspect that you might have Greenstick fracture if you report any nagging or stiffness in the body part on which you fell.
Tests to Diagnose Greenstick Fracture
The medical professionals that deal with Greenstick fracture are called orthopedists. Your medical doctor will certainly refer you to an orthopedist if he/she thinks you might have Greenstick fracture.
Your orthopedist will first perform a physical exam of the area possibly affected by Greenstick fracture. That physical exam will include inspecting the area for:
- Open wounds.
If your kid is suspected to have Greenstick fracture, an orthopedist will ask it to move its fingers to check out for any nerve damage. An orthopedist will also check your kid’s joints below and above the fracture.
However, a final diagnosis of Greenstick fracture is made with the help of X-ray scan test.
Treatment for Greenstick Fracture
Treatment of Greenstick fracture greatly depends on fracture’s severity. It is necessary to treat a child with severe case of Greenstick fracture by immobilizing the affected area with a cast. Removable splints are used for the treatment of less severe cases of Greenstick fracture. A medical professional may also straighten the cracked bone manually. Before this procedure, a sedation drug is given to the patient.
Home Remedies for Greenstick Fracture
There are no known home remedies for Greenstick fracture. However, you can use home remedies for pain if your child has pains associated with its Greenstick fracture.
Recovery Period/Healing Time for Greenstick Fracture
The full recovery period or healing time from Greenstick fracture is about 4 weeks. However, it is anywhere from 2 to 8 weeks.
How Long Does it Take for a Greenstick Fracture to Heal?
Most cases of Greenstick fracture were reported to heal in 4 to 8 weeks. During that time, it is important to wear properly the prescribed cast or a removable splint.
Prevention of Greenstick Fracture
The kids are almost all the time victims of Greenstick fracture. However, there are ways how parents can prevent their children get painful Greenstick fracture.
The best way to prevent Greenstick fracture is to let your child play on a soft surface on which falling down will not cause bone fracture. If your child plans to engage in any sport activity, make sure it uses protective equipment such as knee sleeves etc…
Risk Factors for Greenstick Fracture
The risk of getting Greenstick fracture is highest for children under the age of 10. Children’s bones are softer and break more easily but incompletely. Activities that pose a high risk of falling are also a high risk factor for Greenstick fracture.
Prognosis/Outlook for Greenstick Fracture
The outlook or prognosis for Greenstick fracture is excellent. After a child starts with the treatment of its Greenstick fracture, parents can expect Greenstick fracture to heal approximately in 2 to 8 weeks.
Lifestyle Changes for Greenstick Fracture
Kids that get Greenstick fracture usually cannot go to school 2 to 3 days after the injury. However, after that they will be fully capable of going to school.
Children that get Greenstick fracture in their dominant hand should be helped in everyday activities such as eating and writing until full recovery.
Coping with Greenstick Fracture
Offer your child full emotional and physical support after they are in the process of recovering from Greenstick fracture. Your child might start to feel nervous about wearing a splint or a cast. If so, you should calm down your kid and tell them that he/she will stop wearing splint or cast very soon.
- Podeszwa, David A., et al. “Pediatric Greenstick Fractures of the Forearm: Management and Complications.” Journal of Pediatric Orthopaedics, Volume 35, Issue 3, 2015, pp 285-291. DOI: 10.1097/BPO.0000000000000233
- Wofford, Richard R., et al. “In Brief: Greenstick Fractures.” Clinical Pediatrics, Volume 59, Issue 3, 2020, pp 305-306. DOI: 10.1177/0009922820903379
- Khan, Wasim S., et al. “Epidemiology of Pediatric Fractures Presenting to Emergency Departments in the United States.” Journal of Pediatric Orthopaedics, Volume 40, Issue 4, 2020, e294-e298. DOI: 10.1097/BPO.0000000000001412
- Frontera, Walter R., et al. “Greenstick Fracture.” In Essentials of Physical Medicine and Rehabilitation: Musculoskeletal Disorders, Pain, and Rehabilitation, 4th edition, 2019, pp 359-360. DOI: 10.1016/B978-0-323-40180-4.00033-6
- “Greenstick Fracture – Pediatric.” University of Rochester Medical Center. https://www.urmc.rochester.edu/encyclopedia/content.aspx?contenttypeid=90&contentid=p02704