A fracture when one side of the fractured bone has broken and the other side is bent is called a greenstick fracture. Because of this condition, it is called an incomplete break. This is also known as growth plate injury. Children's bones are still in a developing stage and are more susceptible to greenstick fracture because their bones are more pliable than adults'. This can be compared to the breaking of a fresh branch of a tree. The inner side remains intact even though it is bent while it snaps on one side. It wont result in a complete disruption of the bone's cortex but there will be a bowing at the fractured area.
To bring back the bone into proper position, it has to be bent back and this procedure is called reduction.
A cast for about six weeks will help regain the position. Since greenstick fractures mostly occur in the middle and slower growing parts of the bone, it takes longer time to heal. In a growth plate injury, careful treatment and accurate reduction are necessary for the bone to continue to grow normally. In some cases, plastic deformation of the bone also may occur. This is a condition in which the bone permanently bends but does not break. For such injuries, an osteotomy or bone cut may be necessary to realign the bone if the fracture is a fixed one.
Normally when children fall with outstretched arms, they suffer injuries or broken bones in their hand, wrist, arm and elbow. The orthopedist will request an X-ray of the injured parts. He will also conduct some tests to ensure that blood circulation and nerves in the affected portions are not affected due to the injury. Some symptoms include acute pain, tenderness, swelling, inability to rotate or turn the forearm and any type of deformity about the elbow, forearm or the wrist. Depending on the type of fracture and the degree of displacement, the doctor will decide about the treatment. A surgery is required only if the bones break through the skin and the physician will be able to bring back proper alignment of the bones through manipulation.
Torus fracture also known as buckle fracture is a very common injury suffered by children. The Latin word 'Tori' which means swelling or protuberance explains the origin for the word torus. Known as an incomplete fracture as one side of the bone buckles upon itself without hurting the other side, children are prone to this type of fracture. The bone in the fractured area only bends and does not break.
Considered to be the most common fracture site in young children, this forearm fracture is a common occurrence next to the hand fracture. Both the radius and ulna are involved when the distal third of the forearm is injured. Generally the fractures involving the forearm can be classified under simple torus fracture or greenstick fracture. These incomplete fractures reveal cortical breaking on one side with or without a bulging or buckling of the cortex. Between the two incomplete fractures, torus or buckling fracture is more common. Children sustain this injury more, because their bones are weak due to immature mineralization. The buckling reaction is caused when there is axial stress on the bone.
With adequate rest torus fractures normally heal, but there may be soreness and discomfort in the area of fracture. There may not be any deformity in the case of torus fracture, since the cortex and periosteum are intact on one side of the bone. The orthopedic should carefully examine the x ray to ascertain that the side where there is tension is intact. There is the possibility of a greenstick fracture at the point, if the fracture is not on the compression side. In that case, the fracture may tend to deform in the cast. Casting for a short duration of about three weeks is done to heal torus fracture. Though it is similar to greenstick fracture, healing time is quicker in the case of torus fracture.
Bibliography / Reference
Collection of Pages - Last revised Date: February 16, 2019