A greenstick fracture is a

fracture Fracture is the separation of an object or material into two or more pieces under the action of stress. The fracture of a solid usually occurs due to the development of certain displacement discontinuity surfaces within the solid. If a displ ...

in a young, soft bone in which the bone bends and breaks. Greenstick fractures occur most often during infancy and childhood when bones are soft. The name is by analogy with green (i.e., fresh) wood which similarly breaks on the outside when bent.

Signs and symptoms

Some clinical features of a greenstick fracture are similar to those of a standard long bone fracture greenstick fractures normally cause pain at the injured area. As these fractures are specifically a pediatric problem, an older child will be protective of the fractured part and babies may cry inconsolably. As per a standard fracture, the area may be swollen and either red or bruised. Greenstick fractures are stable fractures as a part of the bone remains intact and unbroken so this type of fracture normally causes a bend to the injured part, rather than a distinct deformity, which is problematic. Symptoms include pain in the area and can start from overuse in that specific bone. This can be a very gradual chronic pain or pain from a specific injury.

Risk factors

The greenstick fracture pattern occurs as a result of bending forces. Activities with a high risk of falling are risk factors.

Non-accidental injury Child abuse (also called child endangerment or child maltreatment) is physical, sexual, and/or psychological maltreatment or neglect of a child or children, especially by a parent or a caregiver. Child abuse may include any act or failure to a ...

more commonly causes spiral (twisting) fractures but a blow on the

forearm The forearm is the region of the upper limb between the elbow and the wrist. The term forearm is used in anatomy to distinguish it from the arm, a word which is most often used to describe the entire appendage of the upper limb, but which in ...

or shin could cause a greenstick fracture. The fracture usually occurs in children and teens because their bones are flexible, unlike adults whose more brittle bones usually break.

Diagnosis

Projectional radiography Projectional radiography, also known as conventional radiography, is a form of radiography and medical imaging that produces two-dimensional images by x-ray radiation. The image acquisition is generally performed by radiographers, and the images a ...

is generally preferable.

Treatment

Removable

splints Splints is an ailment of the horse or pony, characterized by a hard, bony swelling, usually on the inside of a front leg, lying between the splint and cannon bone or on the splint bone itself. It may be "hot," meaning that it occurred recently ...

result in better outcomes than

casting Casting is a manufacturing process in which a liquid material is usually poured into a mold, which contains a hollow cavity of the desired shape, and then allowed to solidify. The solidified part is also known as a ''casting'', which is ejecte ...

in children with

torus fracture A Torus fracture, also known as a buckle fracture is the most common fracture in children. It is a common occurrence following a fall, as the wrist absorbs most of the impact and compresses the bony cortex on one side and remains intact on the oth ...

s of the distal

radius In classical geometry, a radius (plural, : radii) of a circle or sphere is any of the line segments from its Centre (geometry), center to its perimeter, and in more modern usage, it is also their length. The name comes from the latin ''radius'', ...

. If a person is doing better after 4 weeks, repeat X rays are not needed.

Fossil record

Evidence for greenstick fractures found in the fossil record is studied by

paleopathologists Paleopathology, also spelled palaeopathology, is the study of ancient diseases and injuries in organisms through the examination of fossils, mummified tissue, skeletal remains, and analysis of coprolites. Specific sources in the study of ancient ...

, specialists in ancient disease and injury. Greenstick fractures (willow breaks) have been reported in fossils of the large carnivorous dinosaur ''

Allosaurus fragilis ''Allosaurus'' () is a genus of large carnosaurian theropod dinosaur that lived 155 to 145 million years ago during the Late Jurassic epoch ( Kimmeridgian to late Tithonian). The name "''Allosaurus''" means "different lizard" alludi ...

''.Molnar, R. E., 2001, Theropod paleopathology: a literature survey: In: Mesozoic Vertebrate Life, edited by Tanke, D. H., and Carpenter, K., Indiana University Press, p. 337-363. Greenstick fractures are found in the fossil remains of

Lucy Lucy is an English feminine given name derived from the Latin masculine given name Lucius with the meaning ''as of light'' (''born at dawn or daylight'', maybe also ''shiny'', or ''of light complexion''). Alternative spellings are Luci, Luce, Lu ...

, the most famous specimen of ''

Australopithecus afarensis ''Australopithecus afarensis'' is an extinct species of australopithecine which lived from about 3.9–2.9 million years ago (mya) in the Pliocene of East Africa. The first fossils were discovered in the 1930s, but major fossil finds would no ...

'', discovered in Ethiopia in 1974. Analysis of bone fracture patterns, which include a large number of greenstick fractures in the forearms, lower limbs, pelvis, thorax and skull, suggest that Lucy died from a vertical fall and impact with the ground.

References

External links

Radiology
Greenstick vs Torus Fractures {{Fractures Bone fractures