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 your 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?
April 28, 2016
References
  1. Marx JA, et al., eds. General principles of orthopedic injuries. In: Rosen's Emergency Medicine: Concepts and Clinical Practice. 8th ed. Philadelphia, Pa.: Saunders Elsevier; 2014. http://www.clinicalkey.com. Accessed March 21, 2016.
  2. Kliegman RM, et al. Common fractures. In: Nelson Textbook of Pediatrics. 20th ed. Philadelphia, Pa.: Elsevier; 2016. http://www.clinicalkey.com. Accessed March 21, 2016.
  3. Schweich P. Distal forearm fractures in children: Diagnosis and assessment. http://www.uptodate.com/home. Accessed March 21, 2016.
  4. Mencio GA. Fractures and dislocations of the forearm, wrist and hand. In: Green's Skeletal Trauma in Children. 5th ed. Philadelphia, Pa.: Saunders Elsevier; 2015. http://www.clinicalkey.com. Accessed March 21, 2016.
  5. Mathison DJ, et al. General principles of fracture management: Fracture patterns and description in children. http://www.uptodate.com/home. March 21, 2016.
  6. Schweich P. Distal forearm fractures in children: Initial management. http://www.uptodate.com/home. Accessed March 21, 2016.
  7. Schweich P. Closed reduction and casting of distal forearm fractures in children. http://www.uptodate.com/home. Accessed March 21, 2016.
  8. Herring JA. Upper extremity injuries. In: Tachdjian's Pediatric Orthopedics. 5th ed. Philadelphia, Pa.: Saunders Elsevier; 2014. http://www.clinicalkey.com. Accessed March 21, 2016.