Greenstick fracture

(Redirected from Greenstick Fracture)

Background

  • Cortical disruption and periosteal tearing on convex side of bone only
  • More stable / less painful than complete fracture

Clinical Features

  • Pediatric fracture type
Radius and ulna greenstick fractures

Differential Diagnosis

Evaluation

  • Ultrasound scanning seems to be as sensitive as plain x-rays and may be better at demonstrating the degree of cortical deformity

Management

  • Need for reduction determined by angulation, location, and age of child
  • As a general rule, manipulation may be considered for deformity obvious to the naked eye or if more than the following acceptable angles[1]:
    • >10 years old then < 10 degrees is acceptable.
    • <10 years old then < 15 degrees is acceptable.

Traditionally these fractures have been treated by immobilisation in plaster for a period of around 3 to 6 weeks

  • Fractures not requiring manipulation have a universally good outcome regardless of treatment
  • Higher levels of patient satisfaction with a Futura type splint

Disposition

  • Patients not requiring manipulation can be discharged with a backslab and advice to remove in 3 weeks or a Futura type splint and advice to remove when comfortable. There is no evidence that routine follow up is necessary.

See Also

References

  1. Cadman, E. Wrist torus and greenstick fractures, Don't Forget the Bubbles, 2019. Available at: http://doi.org/10.31440/DFTB.21125

Authors:

Ross Donaldson