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Background: To break or not to break-That is the question that has been asked in pediatric traumatology for many years regarding the treatment of greenstick fractures of the diaphyseal forearm shaft.
Objective: The frequency of greenstick fractures of the forearm shaft in children and adolescents; the influence of breaking the fracture on the refracture rate.
Methods: Analysis and discussion of relevant articles, analysis of the refracture rate of pediatric greenstick fractures of the forearm shaft in our own patient population.
Results: Greenstick fractures frequently occur in the area of the forearm shaft and incomplete consolidation leads to an increased refracture rate. In the patient collective of the authors of 420 children with greenstick fractures of the diaphyseal forearm, there was a refracture rate of 9.5%; however, the rate for non-completed fractures was significantly higher compared to the group with completed fractures (15.2% vs. 3%). While in the subgroup of conservatively treated fractures (n = 234), breaking the intact cortex significantly reduced the refracture rate, breaking the intact cortical bone during surgical treatment with elastic stable intramedullary nailing (ESIN) did not change the refracture rate.
Conclusion: As part of the conservative treatment of greenstick fractures of the diaphyseal forearm, completing the fracture can be recommended in order to lower the refracture rate. Completing the fracture does not appear to be necessary during surgical treatment using ESIN.
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http://dx.doi.org/10.1007/s00113-024-01477-3 | DOI Listing |
Cureus
August 2025
Department of Radiology, Faculty of Medicine, Khon Kaen University, Khon Kaen, THA.
Purpose: To investigate the accuracy of radiographic diagnosis of pediatric hand fractures and factors that contribute to diagnostic errors.
Methodology: We retrospectively reviewed cases of pediatric hand injuries in Srinagarind Hospital, Thailand, from January 2019 to December 2021. A total of 350 patients with accessible radiographs were interpreted by junior/senior radiology trainees, a pediatric/a senior radiologist, and two senior orthopedists.
J Orthop Case Rep
August 2025
Department of Orthopaedic Surgery, Avenue Hippocrate, Cliniques Universitaires Saint-Luc, Brussels, Belgium.
Introduction: Association of elbow dislocation, radial neck fracture (RNF), and ulnar shaft fracture has not been reported previously in the pediatric population.
Case Report: This 11-year-old girl fell from her height. She presented a severely displaced RNF, a greenstick fracture of the proximal ulnar shaft, and a posterior elbow dislocation.
J Orthop
September 2025
Department of Physical Therapy for Musculoskeletal Disorders and its Surgery, Faculty of Physical Therapy, Cairo University, Egypt.
Background: Greenstick fractures are common forearm injuries in children, with 75-84 % occurring in the distal third of the radius. Conservative treatments such as detachable braces or plaster backslabs permit early physiotherapy intervention, including muscle activation exercises and electrotherapy. This study investigated the biomechanical and electrophysiological effects on fracture healing to improve bone strength and reduce refracture risk, using finite element analysis (FEA) and experimental validation.
View Article and Find Full Text PDFJ Pediatr Soc North Am
August 2025
Division of Sports Medicine, University of California, Los Angeles, Los Angeles, CA, USA.
Background: Epidemiological data for pediatric fracture are limited, especially specific to the United States. Recent cohort studies from emergency departments and orthopaedic surgery clinics potentially skew data to more severe diagnoses. This retrospective cross-sectional study aims to update the epidemiology of pediatric fracture patients who presented to a pediatric orthopaedic urgent care center in an urban location.
View Article and Find Full Text PDFUnfallchirurgie (Heidelb)
June 2025
Klinik für Unfall- und Wiederherstellungschirurgie, BG-Klinik Tübingen, Eberhard Karls Universität Tübingen, Tübingen, Deutschland.
Shaft fractures in children and adolescents differ from those of adulthood in terms of the fracture pattern and treatment. With respect to the procedure, humeral shaft fractures must be differentiated from forearm shaft fractures. Almost no axial deviation can be tolerated on the forearm shaft, even at a young age as this could lead to functional restrictions in the rotation of the forearm.
View Article and Find Full Text PDF