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Greenstick fracture
From WikEM
Contents
Background
- Cortical disruption and periosteal tearing on convex side of bone only
- More stable / less painful than complete fracture
Clinical Features
- Pediatric fracture type
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 dorsal angulation of more than 10 degrees of the joint line in the lateral projection (if plain x-rays are used)
- 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.
