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 an 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?