Greenstick
fractures
Overview
A greenstick fracture occurs when a bone bends
and cracks, instead of breaking completely into separate pieces. The fracture
looks similar to what happens when you try to break a small, "green"
branch on a tree.
Most greenstick fractures occur in children
younger than 10 years of age. This type of broken bone most commonly occurs in
children because their bones are softer and more flexible than are the bones of
adults.
Even mild greenstick fractures are usually immobilized
in a cast. In addition to holding the cracked pieces of the bone together so
they can heal, a cast can help prevent the bone from breaking all the way
through if the child falls on it again.
Symptoms
Signs and symptoms will vary, depending on the
severity of the greenstick fracture. Mild fractures might be mistaken for
sprains or bruises. More-severe greenstick fractures may cause an obvious
deformity, accompanied by significant pain and swelling.
When to see a doctor
Contact your doctor if your child has
persistent pain in an injured limb. Seek immediate medical attention if a child
is unable to bear weight or if there is obvious pain, deformity and swelling.
Causes
Childhood fractures most commonly occur with a
fall. Arm fractures are more common than leg fractures, since the common
reaction is to throw out your arms to catch yourself when you fall.
Risk factors
The risk of greenstick fractures is higher in
young children because their bones are softer and more flexible than adult
bones. In a greenstick fracture, the bone bends and cracks instead of breaking
into separate pieces. Most greenstick fractures occur in children under age 10.
Diagnosis
During the physical exam, your doctor will
inspect the affected area for tenderness, swelling, deformity, numbness or an
open wound. Your child may be asked to move his or her fingers into certain
patterns or motions to check for nerve damage. Your doctor may also examine the
joints above and below the fracture.
X-rays can reveal most greenstick fractures.
Your doctor may want to take X-rays of the uninjured limb, for comparison
purposes.
Treatment
Depending on the severity of the greenstick
fracture, the doctor may need to straighten the bone manually so it will heal
properly. Your child will receive pain medication and possibly sedation drugs
for this procedure.
Greenstick fractures have a high risk of
breaking completely through the bone, so most of these types of fractures are
immobilized in a cast during healing.
On occasion, your doctor may decide that a
removable splint could work just as well, particularly if the break is mostly
healed. The benefit of a splint is that your child might be able to take it off
briefly for a bath or shower.
X-rays are required in a few weeks to make
sure the fracture is healing properly, to check the alignment of the bone, and
to determine when a cast is no longer needed. Most greenstick fractures require
four to eight weeks for complete healing, depending on the break and the age of
the child.
Preparing for your appointment
If your child has significant pain or an
obvious deformity, you might go straight to an emergency room or urgent care
clinic. The doctor who first examines your child may recommend a consultation
with a pediatric orthopedic surgeon.
What you can do
To prepare for your conversation with the
doctor, you may want to write a quick list that includes:
·
Your child's symptoms
·
How the injury
occurred
·
Your child's key
medical information, including any previous fractures, other medical problems,
allergies, and the names of all medications and vitamins he or she takes
·
Any other questions
you want to ask the doctor
Remember to bring a copy of any X-ray images
(usually on a disk) and medical notes if your child has already been seen at an
urgent care clinic or another medical center.
What to expect from
your doctor
Your doctor may ask:
·
Was there a clear
injury associated with the beginning of symptoms?
·
Has your child been
able to walk or bear weight on the limb?
·
Where exactly does it
hurt?
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