Greenstick Fractures

What are greenstick fractures?

A greenstick fracture is a type of bone fracture (broken bone). Greenstick fractures happen when something bends a bone enough to crack it without breaking it into multiple pieces.

Greenstick fractures get their name from the shape (pattern) of the break in your bone. Picture the difference between snapping a young, green twig and an older, dried out branch. Green twigs bend without snapping, but — at a certain point — they crack or splinter where you’re bending them. Older branches snap cleanly apart. Greenstick fractures are the same as bending that young twig — a break along one side of a bone that doesn’t snap it into more than one piece.

Almost all greenstick fractures happen to children younger than 10 because kids have softer and less brittle bones than adults.

Your child will probably need to wear a cast while their bone heals after a greenstick fracture. More severe fractures require surgery to repair — especially if they have other injuries.

Types of greenstick fractures

Greenstick fractures usually affect longer bones, including your:

• Humerus (upper arm bone).
• Radius and ulna (forearm bones).
• Phalanges (finger and toe bones).
• Femur (thigh bone).
• Fibula (calf bone).

How common are they?

Greenstick fractures are extremely common injuries, especially for children. Millions of kids experience a greenstick fracture every year in the U.S.

What are greenstick fracture symptoms?

The most common greenstick fracture symptoms include:

• Pain.
• Bruising or discoloration.
• Tenderness.
• Swelling.
• Part of your child’s body looking more bent or twisted than usual.

What causes greenstick fractures?

Anything that puts a lot of force on one of your child’s long bones can cause a greenstick fracture. The most common causes include:

• Falls (especially catching themselves from a fall with outstretched hands).
• Sports injuries.
• Car accidents.

What are the risk factors for greenstick fractures?

Anyone can experience a greenstick fracture, but it almost always affects children younger than 10. Kids are more likely to experience a greenstick fracture because their bones aren’t fully developed — they’re softer and more pliable than adults’ bones.

Young children are also more likely to experience greenstick fractures because they fall more than most adults. Kids younger than 10 are especially likely to catch themselves with their hands, wrists and arms outstretched.

Children with malnutrition or a vitamin D deficiency are also more likely to break a bone.

Adults can experience greenstick fractures, but it’s rare. It’s much more common for adults’ bones to break into multiple pieces.

How are greenstick fractures diagnosed?

A healthcare provider will diagnose a greenstick fracture with a physical exam and imaging tests.

They’ll examine your child’s injury and the area around it. Tell their provider as much information as you can about what your child was doing before they were hurt (especially if you know they fell or got hit during sports or another physical activity).

What tests do providers use to diagnose fractures?

Your provider will use X-rays to take pictures of your child’s bones to confirm a greenstick fracture. They may also use magnetic resonance imaging (MRI) or a computed tomography (CT) scan to take three-dimensional pictures of your child’s bones and the surrounding tissue (especially if they need surgery).

What are greenstick fracture treatments?

Providers treat most greenstick fractures by immobilizing the bone (keeping it from moving) with a cast. Your child will probably need to wear a cast for around six weeks. They’ll need follow-up X-rays to make sure their bone is healing correctly.

Greenstick fracture surgery

Your child might need surgery to repair their bone, especially if the greenstick fracture has a severe angle (bend).

Your surgeon will realign (set) your child’s bone to its correct position and secure it in place so it can heal and grow back together. They usually perform what’s called an internal fixation, which means your surgeon inserts metal pins into your child’s bone to hold it in place. They might need follow-up procedures to remove the pins after their bone has healed.

Greenstick fracture surgery complications

The most common greenstick fracture surgery complications include:

• Malunion: This happens when a broken bone doesn’t line up correctly while it heals.
• Nonunion: A bone may not grow back together fully or at all.
• Acute compartment syndrome (ACS): A buildup of pressure in the muscles may stop blood from getting to tissue, which can cause permanent muscle and nerve damage.

How can I prevent greenstick fractures?

You may not be able to prevent a greenstick fracture, especially if your child falls or experiences another type of trauma. But there are a few ways you can reduce your family’s injury risk:

• Always wear your seatbelt.
• Make sure everyone wears the right protective equipment for all activities and sports.
• Make sure your home is free of clutter that could trip anyone.
• Always use the proper tools or equipment at home to reach things. Never let children stand on chairs, tables or countertops.

What can I expect if my child has a greenstick fracture?

Most children who experience a greenstick fracture fully recover and can resume all their usual activities after their bone heals. Talk to your healthcare provider before your child resumes any physical activities or plays sports.

Kids who experience a greenstick fracture in their forearm bones may have an increased risk of re-breaking that same bone in the future. This is especially true if a healthcare provider doesn’t diagnose and treat the fracture right away. Visit a provider as soon as your child has symptoms like pain or swelling around a bone.

Healing time

Most greenstick fractures take around six weeks to heal. How long it’ll take depends on which of your child’s bones is broken, the fracture’s severity and if they experienced any other injuries. Your provider will tell you what to expect, and when they can resume physical activities.

When should I see my healthcare provider?

Visit a healthcare provider if your child has pain or swelling around a bone — especially if they experience a fall or another injury.

When should I go to the emergency room?

Go to the ER if you experience trauma or think your child has a broken bone. Go to the emergency room if your child experiences any of the following:

• Intense pain.
• They can’t move a part of their body.
• A part of their body is noticeably different-looking or out of its usual place.
• You can see their bone through their skin.
• Swelling.
• New bruising that appears at the same time as any of these other symptoms.

What questions should I ask my healthcare provider?

Questions to ask your healthcare provider include:

• Does my child have a greenstick fracture or another injury?
• How long will they need to wear a cast?
• Will they need surgery?
• How long will it take them to recover?
• How do I take care of my child’s cast?
• What activities are safe to do while my child’s recovering?
• What is my child’s risk of future fractures?

A note from Cleveland Clinic

Knowing that your child is in pain is always scary and frustrating — especially if they have a broken bone. It’s perfectly natural to be concerned and have questions. The good news is that most kids who experience a greenstick fracture have no long-term effects or complications after their bone heals.

Talk to your healthcare provider about what to expect. They’ll tell you how you can help your child stay safe while they’re healing.