Greenstick Fractures

Overview

What is a greenstick fracture?

A greenstick fracture is a crack or break on one side of a long bone in the arm or leg. The crack or break does not extend all the way through the bone. It is named for the way a fresh green twig behaves when bent.

Who is most at risk for greenstick fractures?

Children are more likely to have greenstick fractures because their bones are softer and less brittle than an adult’s.

How common are greenstick fractures?

Greenstick fractures are very common. In the United States, millions of children are affected each year. A greenstick fracture often occurs when a child falls and tries to break the fall with his or her arms.

Symptoms and Causes

What causes greenstick fractures?

Greenstick fractures result from the bending of a bone. Any force that bends a long bone, such as an arm or leg bone, without fully breaking it can cause a greenstick fracture. Instead of snapping into two pieces, the bone cracks on one side.

Greenstick fractures can be caused by many things, including participation in sports, motor vehicle accidents and falls.

What are the symptoms of greenstick fractures?

The symptoms of a greenstick fracture depend on the severity of the crack. Symptoms of greenstick fractures include:

  • Pain
  • Bruising
  • Tenderness
  • Swelling
  • Deformity (a bending or twisting) of the affected body part

Diagnosis and Tests

How are greenstick fractures diagnosed?

To diagnose a greenstick fracture, the doctor will perform a physical examination and ask how the injury occurred. The doctor will also inspect the injured area for signs of a fracture, including pain and swelling.

If needed, the doctor will order X-rays to make sure the bone is fractured. A CT (computed tomography) scan or MRI (magnetic resonance imaging) scan may confirm the diagnosis and rule out other injuries. The doctor is most likely to order these imaging tests if the fracture occurs because of major trauma.

Management and Treatment

How are greenstick fractures treated?

In most cases, greenstick fractures are treated by immobilizing the bone (keeping it from moving) with a cast or a splint. Most casts remain in place for 4-6 weeks. For pain, the doctor may prescribe acetaminophen (Tylenol®) or a nonsteroidal anti-inflammatory medication (NSAID), such as ibuprofen (Advil® or Motrin®) or naproxen (Aleve®).

Some patients need surgery for more serious greenstick fractures. Surgery may be done to realign the bone. The doctor may insert a slender rod or a metal plate with screws into the bone surrounding the fracture to maintain alignment while the bone is healing. The metal plates may be permanent, or your surgeon may remove them after you heal.

What complications are associated with greenstick fractures?

Complications from greenstick fractures are rare, but can include:

  • Bleeding
  • Infection
  • Nerve or vascular (blood vessel) injury
  • Malunion (bone deformity that lasts after treatment is complete)

Prevention

Can greenstick fractures be prevented?

You can lower your child’s risk for greenstick fractures by providing appropriate safety equipment for playing sports, and by trying to prevent falls or other injuries that lead to fractures.

Outlook / Prognosis

What is the outlook for patients after treatment for greenstick fractures?

With treatment, most people recover fully from greenstick fractures.

Living With

When should I call my doctor about a greenstick fracture?

Contact your doctor if your child has an injury and has pain and swelling around a bone.

Last reviewed by a Cleveland Clinic medical professional on 05/18/2018.

References

  • American Academy of Orthopaedic Surgeons. . Accessed 5/18/2018.Forearm Fractures in Children (https://orthoinfo.aaos.org/en/diseases--conditions/forearm-fractures-in-children/)
  • Merck Manual Consumer Version. . Accessed 5/18/2018.Overview of Fractures (http://www.merckmanuals.com/home/injuries-and-poisoning/fractures/overview-of-fractures)
  • American Academy of Orthopaedic Surgeons. . Accessed 5/18/2018.Fractures (Broken Bones) (https://orthoinfo.aaos.org/en/diseases--conditions/fractures-broken-bones)

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