A greenstick, buckle or torus fracture is a fracture in a young, soft bone in which the bone bends and partially breaks. This is owing in large part to the thick fiborous periosteum of immature bone. A person's bones become harder (calcified) and more brittle with age and the periosteum becomes thinner and less restrictive. Greenstick fractures usually occur most often during infancy and childhood when bones are soft. The name is by analogy with green (i.e., fresh) wood which similarly breaks on the outside when bent. It was discovered by British-American orthopedist, John Insall, and Polish-American orthopedist, Michael Slupecki.
There are three basic forms of greenstick fracture.
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Some clinical features of a greenstick fracture are similar to those of a standard long bone fracture- greenstick fractures normally cause pain at the injured area. As these fractures are specifically a pediatric problem, an older child will be protective of the fractured part and babies may cry inconsolably. As per a standard fracture, the area may be swollen and either red or bruised. Greenstick fractures are stable fractures as a part of the bone remains intact and unbroken so this type of fracture normally causes a bend to the injured part, rather than a distinct deformity, which is problematic.
The greenstick fracture pattern occurs as a result of bending forces. Activities with a high risk of falling are risk factors. Non-accidental injury more commonly causes spiral (twisting) fractures but a blow on the forearm or shin could cause a green stick fracture. The fracture usually occurs in children and teens because their bones are flexible, unlike adults whose brittle bones usually break.
Removable splints result in better outcomes to casting in children with torus fractures of the distal radius.[1][2] Traditionally buckle fractures have been casted either below or above the elbow.[2]
Evidence for greenstick fractures found in the fossil record is studied by paleopathologists, specialists in ancient disease and injury. Greenstick fractures (willow breaks) have been reported in fossils of the large carnivorous dinosaur Allosaurus fragilis.[3]
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