Which statement best describes the imaging appearance of a greenstick fracture?

Which statement best describes the imaging appearance of a greenstick fracture?

• A. Fracture lines across both cortices
• B. Periosteal reaction on convex side
• C. Complete disruption of both cortices
• D. Cortical disruption on the convex side with intact periosteum on the concave side

Answer: (D)

Greenstick fractures occur in children when the bone bends and cracks only partway through, rather than breaking completely. On imaging, the tensile side (the convex side) shows cortical disruption where the bone begins to crack, while the opposite side (the concave or compression side) keeps its periosteum intact. This combination—bending with partial cortical disruption on the convex side and an intact periosteum on the concave side—is characteristic of a greenstick fracture. The other patterns imply a complete break through both cortices or periosteal changes on the wrong side, which are not typical of greenstick injuries.

Greenstick fractures occur in children when the bone bends and cracks only partway through, rather than breaking completely. On imaging, the tensile side (the convex side) shows cortical disruption where the bone begins to crack, while the opposite side (the concave or compression side) keeps its periosteum intact. This combination—bending with partial cortical disruption on the convex side and an intact periosteum on the concave side—is characteristic of a greenstick fracture. The other patterns imply a complete break through both cortices or periosteal changes on the wrong side, which are not typical of greenstick injuries.