A child sustains a long bone fracture. An X-ray shows that the cortex is fractured on one side, while the opposite cortex remains intact. Which type of fracture is this?

1. A

   Transverse fracture

2. B

   Spiral fracture

3. C

   Greenstick fracture

4. D

   Oblique fracture

Appeared in: AIIMS M.Sc. Nsg Entrance exam-2026

Explanation

• A greenstick fracture is defined as an incomplete fracture where the bone is bent, causing failure on the tension (convex) side while the compression (concave) side remains intact.
• This type of fracture is almost exclusive to children because their bones are less dense, more porous, and have a thicker periosteum, allowing them to bend and partially break rather than snapping completely.
• The name comes from the analogy of breaking a young, 'green' stick, which splinters on one side instead of breaking cleanly through.
• The description in the question—cortex fractured on one side with the opposite cortex intact—is the textbook definition of a greenstick fracture.

Why Other Options Were Wrong

• Option A: A transverse fracture is a complete fracture that goes straight across the bone (perpendicular to the long axis). This contradicts the question's description of an incomplete fracture where one cortex remains intact.
• Option B: A spiral fracture is a complete fracture caused by a twisting or rotational force, resulting in a fracture line that wraps around the bone. This does not match the description of a one-sided break.
• Option D: An oblique fracture is a complete fracture where the bone breaks at a diagonal angle across the bone shaft. This is a complete break through both cortices, unlike the fracture described.

Related Visual

• Visual 1: Diagram - An illustration comparing the four main fracture patterns: transverse, spiral, oblique, and greenstick. This helps to visually differentiate between a complete fracture and the incomplete nature of a greenstick fracture.
• Visual 2: X-ray - A sample X-ray of a child's forearm showing a greenstick fracture of the radius or ulna, clearly demonstrating the break on one cortex and the bending of the other.

Clinical Relevance

• Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Classification of bone fractures based on radiographic appearance in children as background academic context rather than a clinical decision trigger.
• Recognizing a greenstick fracture is crucial as it is almost exclusively a pediatric injury. Its presence in an adult would suggest an underlying bone pathology like osteomalacia.
• Management is typically conservative with immobilization in a cast to allow the bone to heal and remodel. It's important to ensure proper alignment as the intact cortex can cause the fracture to angulate.
• Nurses must educate parents on cast care, monitoring for signs of neurovascular compromise (pain, pallor, pulselessness, paresthesia, paralysis), and the importance of follow-up appointments to monitor healing.

How to Approach the Question

• First, identify the key information in the clinical scenario: the patient is a child, and the fracture is incomplete (broken on one side, intact on the other).
• The patient's age (child) is a major clue, as certain fracture types are unique to the pediatric population due to the nature of their growing bones.
• Focus on the specific description of the fracture: 'cortex is fractured on one side, while the opposite cortex remains intact.' This is the defining feature.
• Review the definitions of the fracture types provided in the options.
• A transverse, spiral, or oblique fracture are all types of 'complete' fractures, meaning the bone breaks into two or more pieces. This contradicts the stem.
• A greenstick fracture is, by definition, an incomplete fracture common in children that matches the description perfectly. Therefore, it is the correct answer.

Concept Tested & Keywords

• Concept Tested: Classification of bone fractures based on radiographic appearance in children.
• Stem keywords: child, long bone fracture, cortex fractured on one side, opposite cortex intact
• Lead-in keywords: Which type
• Clinical cues: [object Object]
• Negative lead-in flag: false

Question ID

QmSVBx_F1cjhVU7xGetgR5

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