Skull fracture in a child: consequences, symptoms and treatment regimen for infants and older

Last Updated on 06/23/2017 by Perelomanet

The paired flat part of the skull, the parietal bone, resembles a rectangle, curved on the inside, but looks convex and smooth on the outside. Located in the upper and lateral parts of the skull.

The most prominent part is the parietal tubercle. From the inside, this bone contains parts of the cerebral convolutions and arterial grooves that nourish the lining of the brain. The crown is a bony structure that is divided into four distinct edges:

• anterior - this edge is connected to the upper structure of the forehead;
• occipital – combined with the bone of the occipital part;
• lateral – combined with the temple bone;
• medial - an edge that is connected in the central region of the skull by a sagittal suture with the opposite parietal bone.

A fracture of one of the parts of the parietal bone is considered a very serious injury, since it can subsequently worsen the functioning of brain activity.

Possible consequences and first aid

When the bones at the base of the skull are damaged, the consequences can be divided into immediate and long-term. Let's look at both types in more detail.

Emergency conditions of the body

These consequences require prompt medical intervention. Emergency conditions are characterized by the formation of blood clots in the back of the skull, which compress the medulla. With such an injury, there is a high probability of developing an inflammatory process due to the penetration of pathogenic microorganisms.

When a child has a skull fracture, the consequences can be varied. Epidural hematomas often form due to damage to blood vessels. The described damage leads to disruption of the integrity of the nerve fibers and the entry of air into the cerebrospinal fluid. Pathogenic microorganisms also penetrate into the latter.

Linear injuries are especially dangerous for young children. They lead to the formation of hematomas that compress the brain matter. Hematomas increase gradually, reaching their maximum size within about two weeks. During this period, children need special care, as their lives are at particular risk.

With a depressed fracture, the bones that make up the parietal or frontal lobe are damaged. If an open wound has formed after an injury, pathogenic microorganisms can penetrate into it, contributing to:

• the appearance of seizures;
• development of neurological pathologies;
• the occurrence of death.

Among the complications that arise against the background of a depressed fracture, the following phenomena stand out:

• strabismus;
• meningitis;
• impaired motor functions of the eyeballs;
• brain abscess;
• nystagmus;
• decreased foot function.

Depending on the nature of the injury, a fracture of the base of the skull can lead to:

• paralysis of the tongue and the whole body;
• curvature of the spine;
• ringing in my ears;
• attacks of dizziness;
• visual disorders;
• of death.

In infants, damage to the bones of the skull contributes to the formation of:

• swelling of soft tissues;
• stagnation of venous blood;
• generic tumor.

Even after eliminating the hematoma in infants, there is a possibility of the following:

• meningoencephalitis;
• cerebral palsy;
• hyperkinesis;
• convulsive seizures.

Long-term complications

Such consequences do not appear immediately, but over time. In the first few years of life in children, the skull bones are highly elastic. Therefore, fractures are detected less frequently in them than in adults. However, if the skull is damaged in infancy, the following negative consequences appear as the child grows up:

• decreased memory and motor skills;
• behavior change;
• psycho-emotional disorders;
• frequent outbursts of anger;
• hearing impairment;
• damage to the optic nerve;
• spasms of the blood vessels passing through the retina.

Skull fractures in childhood can lead to:

• ischemic strokes;
• aneurysm dissection;
• neurological pathologies.

The likelihood of certain consequences occurring is difficult to predict. In the event of a skull injury in a child, it is necessary to seek qualified medical help. A number of fractures have no external manifestations, but can lead to quite serious consequences as the child grows older.

How to help a child?

If the bones of the skull are damaged, the victim must be placed on a horizontal surface. You cannot put a pillow under your head. If the patient has lost consciousness due to injury, he should lie half-turned. The head should be turned to the side, as there is a possibility of vomiting.

It is recommended to apply ice to the damaged area. Wounds should be covered with a pressure aseptic bandage. If a patient is diagnosed with difficulty breathing, narcotic analgesics should not be given to him. Such drugs worsen a person's condition. After this, the injured child must be taken to the clinic for a comprehensive examination.

A skull fracture in children is a dangerous condition that can lead to many serious consequences, including death. It is not always possible to determine the presence of such injuries in a child due to the absence of clear symptoms. But regardless of the severity of the injury, it is necessary to urgently take the victim to the hospital.

Causes of fracture

In order to understand what can affect the integrity of the bone, you need to understand the structure of the skull and possible injuries.

The parietal bone is a paired flat part of the skull , which looks smooth and slightly convex on the outside, but is curved on the inside. The main location is the upper and lateral part of the skull.

The crown can be divided into four edges:

• occipital - located behind,
• lateral - the side part that connects to the temple,
• medial - touches the second parietal bone through the sagittal suture,
• anterior - located, respectively, in front and connects to the upper part of the forehead.

Any violation of the integrity of the bones is a serious injury, which can subsequently have a serious impact on human development , as well as disturbances in the functioning of the brain and nervous system as a whole.

Particular attention should be paid to infants, since any head injury can affect the psychological and physical development of the child in the future.

The cause of a parietal bone fracture can be:

• increased pressure on the skull,
• direct blow to the head
• fall with injury
• road accident,
• in a baby during childbirth.

Children are most susceptible to fractures during play, since activity and mobility lead to falls and impacts , which can cause serious injury leading to serious consequences.

For example, while playing, a child may fall or drop something or pull something off the table onto his head.

With such injuries, it may feel like an open fracture has occurred, but this is not always the case, since a blow with a heavy object can cause a separate linear fracture and damage to the skin.

Types of cranial injuries

If a baby develops a large hematoma, it can be fatal. Even if the hematoma is promptly removed through surgery, the baby’s condition can be extremely unstable, during which meningoencephalitis develops, and in more complex situations, cerebral palsy or hypertension.

In infants, bone tissue is at a developmental stage and is highly elastic, so such damage is extremely rare. More often in a newborn you can observe a depressed fracture, in which the bones are pressed into the cavity of the skull.

1. Memory impairment;
2. Motor impairment;
3. Capricious behavior.

Young patients are not able to explain what happened and what discomfort they experience

For this reason, parents pay attention to the following signs of negative health changes:

• Presence of a hematoma or lump;
• Nausea and loss of orientation in space;
• Lethargy and increased agitation;
• Damage to the scalp;
• Visible external signs.

The first sign of injury is a hematoma or lump in the area of ​​impact. A hematoma is formed due to the rupture of small blood vessels. Blood fluid is removed under the scalp. The accumulation of fluid is accompanied by sedimentation of red blood cells. For this reason, the hematoma has a dark color.

If a child does not complain after a fall, parents do not pay attention. But this is a mistake. There are also secondary signs. With a linear fracture, the patient has no external symptoms. But the blow causes the brain to shift in the skull. The membrane of the brain hits the walls of the skull. This causes water hammer.

Doctors also include changes in the child’s emotional state as additional signs. Due to a head injury, the small patient becomes lethargic. In some cases, increased excitability is observed. With such symptoms, it is necessary to limit the child’s movements and call emergency medical help.

Impact with sharp objects is accompanied by damage to the skin. A wound is found on the head. Doctors do not recommend treating the wound surface yourself. Help is provided at the medical center.

Before emergency medical services arrive, parents must follow a number of rules. Initially, it is necessary to immobilize the child. Any careless movement aggravates the patient's condition.

The patient should also be anesthetized. For closed fractures, the child is given an anesthetic drug appropriate for his age. A cooling bandage is applied to the injured area. It helps reduce swelling and has a distracting effect.

If there is a wound on the head, you need to treat it. The edges of the wound are treated with hydrogen peroxide or an aqueous solution of chlorhexidine. It is prohibited to treat deep wounds yourself. A sterile napkin is applied to its surface.

Characteristics of the crown segment

The parietal bone consists of two large segments. It covers 80% of the brain. The segment is located above the frontal, occipital and temporal regions. This part of the skull has several edges.

Doctors identify the following facets:

• Occipital facet;
• Frontal zone;
• Lateral edges;
• Medial - central fusion zone.

The occipital zone is located above the pituitary gland of the brain. In this part, the skull is folded towards the inner corner. The frontal zone is flatter. The facet is attached to the frontal bone. The lateral edges are adjacent to the temporal segments. They also have a curve towards the inside corner.

In a child, the majority of injuries occur in the medial zone. In this area of ​​the skull, two parts of the parietal bone are connected. The medial zone is located in the center of the skull. The medial zone has a convexity. The fusion area is covered with elastic collagen tissue.

In children under one year of age, the bone bonding areas are covered with a thin layer of fibrous tissue. This is the main cause of mild trauma to the skull. Often this problem is discovered after passing through the birth canal.

Features of skull fractures in newborns and infants

Skull fractures after traumatic brain injury occur more often in childhood than in adults due to insufficiently strong skull bones and a larger head/body ratio. The incidence ranges from 25 to 40% among all children with traumatic brain injury, and up to 60% for the group of newborns and infants only.

Linear fractures are the most common form, accounting for more than 70% of all pediatric skull fractures. They occur primarily in infants and young children. Depressed fractures are most often observed in older children (15-25% of the total).

a) Growing skull fractures

(
post-traumatic leptomeningeal cysts
).

Growing skull fractures (ESFs) are skull fractures (usually linear) that tend to widen over time as a result of bone erosion and herniation of the arachnoid.

They are rare, accounting for less than 1% of all skull fractures, and usually occur in children under three years of age. In fact, the rapid expansion of the brain in young children contributes to the development of HCD.

The pathogenesis begins with a rupture of the dura mater under the fracture, followed by dehiscence and erosion of the bony margin due to CSF ​​pulsation.

HCP appears as a palpable, soft, pulsating mass under the scalp at the site of the fracture, gradually increasing in size and becoming apparent within 3 to 6 months after the head injury.

It is usually asymptomatic, but may cause headaches or even cause mass effects or neurological deficits such as hemiparesis and seizures. Cranial x-ray and CT scan demonstrate progressive dehiscence and erosion of the fracture edges.

A CT scan may also reveal protrusion of the arachnoid membrane into the bone foramen and subsequent displacement of the brain. Treatment for cancer involves surgical correction.

In older children, cranial reconstruction may be performed using a split bone graft from the opposite side or adjacent regions.

b) Ping-pong ball type fracture

.

Depressed ping pong ball fractures (PBPs) are seen exclusively in newborns and infants due to the thinness and plasticity of their skull, which can be displaced without rupturing the bones.

PMPs appear as palpable internal curves of the skull with variable diameter and depth. This type of fracture is often diagnosed by simply examining the skin.

Surgical treatment is necessary to avoid possible seizures and/or for cosmetic purposes. The operation usually consists of a short linear incision in the skin and a single burr hole placed adjacent to the depression of the skull.

A Penfield dissector or elevator is inserted through the burr hole and used as a lever to push the fracture back out. Sometimes an obstetric vacuum extractor or breast milk extractor may be used to elevate the fracture.

In newborns, as the skull grows, the soft PMF may rise on its own.

c) Occipital osteodiastasis

. The occurrence of occipital osteodiastasis depends on the processes of separation of the scales and the basal part of the occipital bone and, secondarily, on the mechanism of twisting and compression of the skull.

Before the introduction of CT, this type of traumatic injury was detected only at autopsy.

A-I Growing skull fracture. A. Early radiography of the skull and B. CT scan revealed a linear skull fracture in the parietal region.

B. With a later X-ray of the skull and D. CT, a wide diastasis of the fracture edges with a herniation of the brain is determined.

D. Local soft tissue swelling caused by herniation of brain tissue and cerebrospinal fluid. E. Damaged brain tissue excised after large cratiotomy. G. The torn edges of the dura mater are identified, and a dural insert is implanted. H. Cranioplasty was performed to restore the skull defect.

I. Control postoperative CT: correct reconstruction of the dura mater and bone defect, minimal expansion of the homolateral lateral ventricle.

A, B. Newborn and radiograph of the skull. A typical ping-pong ball fracture of the right parietal bone.

– We also recommend “

Traumatic brain injuries due to child abuse”

Table of contents of the topic “Traumatic brain injury (TBI).”:

Why is craniostenosis dangerous?

The absence of movable sutures in the skull severely limits the brain. Therefore, the sooner help comes for craniostenosis, the higher the likelihood of a complete cure for the child in the future. Compensation mechanisms in infants under 2 years of age are very high, but rehabilitation after this age turns out to be more complex and lengthy. If not treated promptly, the disease can cause the following conditions:

If you do not receive treatment in a timely manner, the disease can cause the following conditions:

• delayed physical, mental, intellectual development;
• disruption of normal brain functions;
• skeletal underdevelopment;
• compression and atrophy of the optic nerve up to complete loss of vision;
• headache;
• ophthalmological diseases;
• death.

What are the consequences of a linear skull fracture in children - how to recover correctly

A linear fracture poses the least danger to a child if first aid is provided correctly and timely treatment. The bones grow together, and severe consequences occur in rare cases.

Linear fracture is an injury characterized by displacement of the skull plates by no more than one centimeter or no displacement. As a result, a line appears that is clearly visible on x-rays.

In certain cases, damage to the integrity of the parietal bone is diagnosed; sometimes the frontal and occipital bones are affected.

In young children, the fracture line may move to the line of cranial sutures; this is a diastatic fracture. Also, upon impact, a hematoma is formed, which becomes the cause of complications.

Symptoms of a linear fracture in children

Common symptoms include:

1. Severe headaches.
2. Bruises under the eyes.
3. Nausea accompanied by vomiting.
4. Disturbance of respiratory rhythm and blood circulation due to brain stem injury.
5. Lack of pupillary response to light stimulus. They neither narrow nor expand.

After an injury, a bruise or wound occurs on the scalp. Bone displacement is not determined by palpation.

Loss or confusion may also occur. After some time, the hematoma increases in size, bruising occurs behind the ears, and nosebleeds of varying intensity occur.

Possible consequences

In medicine, the consequences of a skull fracture in the absence of treatment or improper therapy are usually divided into immediate and long-term. The first group includes those that occur immediately or within a few days after injury.

The second type includes consequences that occur after several months and even years.

Immediate Consequences

Depending on the nature and degree, a linear skull fracture can lead to the following consequences:

1. Paralysis of the body or its individual parts.
2. Rachiocampsis. May have varying degrees.
3. Tinnitus.
4. Dizziness. They have a paroxysmal character.
5. Impaired quality of vision.
6. Death.

In newborns, damage to the bones of the skull can cause stagnation of venous blood, swelling of soft tissues and the appearance of a birth tumor.

Linear pearl is considered one of the mildest skull injuries, since after a course of therapy complications occur in children in rare cases. But trauma in an infant can provoke the development of cerebral palsy, convulsive seizures and hyperkinesis.

In young children, a hematoma can put pressure on the brain. At the same time, it gradually increases in size over two weeks. During this period, the baby’s life is at risk and he needs constant medical supervision and special care.

Long-term complications

These consequences do not occur immediately after injury. They appear at an older age.

If the integrity of the cranium is compromised, as newborns grow, they may experience:

1. Motor impairment.
2. Memory loss.
3. Changes in behavior.
4. Frequent attacks of aggression and anger.
5. Decreased quality of hearing and vision.
6. Psycho-emotional disorders.
7. The appearance of spasms of the blood vessels of the retina.

Once middle age is reached, childhood trauma to the skull significantly increases the risk of ischemic strokes, neurological diseases, and aneurysm dissection.

What every parent should know in the following video:

The likelihood of certain consequences occurring is difficult to predict. If a child hits his head and symptoms of a skull fracture begin to appear, you should immediately contact a specialist.

But it must be remembered that some injuries may not show symptoms, but can cause serious consequences as they grow older.

Symptoms of cephalohematoma

Symptoms of cephalohematoma are especially pronounced 2-3 days after the birth of the child. The shape of the head becomes asymmetrical due to the formation of an elastic and soft formation. The outlines of the swelling coincide with the boundaries of the flat bones of the skull, since the periosteum is firmly attached to their edges. Typical localization of cephalohematoma is the parietal and occipital regions of the head. The skin over the formation is unchanged, elastic, and fluctuation is detected on palpation (fluid movement when pressed). A distinctive feature of kepholohematoma is a gradual increase in formation during the first 2-3 days of the baby’s life. The amount of blood under the periosteum can range from 5 to 150 ml. Under favorable conditions and with a small size, the cephalohematoma regresses on its own within a week after its formation.

With an isolated cephalohematoma, the general condition of the child is satisfactory. In the case of combined pathology, neurological symptoms appear. Most children experience depression of the central nervous system: a sluggish reaction to pathogens, a decrease in the severity of reflexes. Some newborns experience excessive excitation of the central nervous system, such as a hypertensive or hydrocephalic symptom complex.

Violation of the independent regression of cephalohematoma (with a large size of the formation, a blood clotting disorder in an infant) can cause various complications: anemia, resorption hyperbilirubinemia, ossification and infection of the hematoma.

With large cephalohematomas, rapid hemolysis of red blood cells occurs, which is accompanied by a yellowish tint of the skin and visible mucous membranes from the first days of life. This jaundice persists for 10 days or more, in contrast to physiological neonatal jaundice.

Therapeutic measures

By current standards, all children with traumatic brain injury are hospitalized. The implementation of reasonable therapy requires a comprehensive examination of the child, which can only be carried out in a medical institution. Conservative treatment of TBI is carried out by neurosurgeons, neurologists and neuroreanimatologists.

The survey includes a number of studies.

1. Nervous system.
2. Vestibular apparatus.
3. Organs of vision and hearing.
4. Other.

The baby is also prescribed x-rays, computed tomography, and MRI.

After research has been carried out, a diagnosis has been made, and treatment will be prescribed to the child.

Medication therapy for infants is aimed at:

• to eliminate swelling;
• reduce intracranial pressure;
• adjust metabolism and blood flow in the brain;
• other.

Anticonvulsant treatment is given to infants if they have a history of seizures or a burdened position. If necessary, analgesics, muscle relaxants, and antipyretics are prescribed.

The patient is fed through a feeding tube or intravenously when the patient is in a coma.

Surgery is indicated to relieve compression of the brain. Children who have a depressed fracture of the skull bones and hemorrhage inside the skull need surgery.

Parents of infants should be aware that thanks to a comprehensive, adequate examination of the baby, they will be able to correctly and timely treat the injury, achieve recovery and avoid disability.

Diagnosis of injury

First of all, after arriving at the hospital, the doctor conducts a thorough examination of the patient and asks what caused the injury and what the first symptoms were. This diagnostic method will help in the subsequent medical verdict of a specialist.

Next, the doctor directs the patient to an x-ray procedure, which is performed in two projections. If the injury is serious, then during diagnosis the body does not change its position, but only the X-ray machine tube moves.

Often, such damage is diagnosed using MRI and CT. These devices are the most informative and less dangerous than x-rays. But research with their help is also more difficult to carry out; the patient must be completely immobilized during the procedures, otherwise the results may be incorrect, and in the case of children this is not an easy task.

Tomography. Double fracture.

If an isolated linear injury is diagnosed, a lumbar puncture procedure is performed. This will help determine the presence of subarachnoid bleeding in the brain.

After a full examination and study of the results, the attending physician makes his verdict and prescribes the most appropriate method of treatment.

Consequences of a skull fracture in children

Any injury to the skull is accompanied by a disorder of the functions of internal organs. This is due to impaired blood flow in the parts of the brain that regulate the functioning of body systems. Most often it manifests itself in a failure of the outflow of venous blood. The blood vessels begin to narrow greatly, and the child experiences high blood pressure, headaches, vomiting and confusion.

As a result of the injury, the child may suffer from headaches and blood pressure.

The degree of complications depends on the severity of the fracture. After minor injuries, the child develops asthenia - increased fatigue, inability to engage in physical and intellectual labor for a long time. The child becomes irritable and inhibited. In the absence of correction and treatment in the future, this complication affects the mental development of the patient.

With moderate trauma, asthenia is accompanied by impaired coordination and increased intracranial pressure. Severe injuries are accompanied by complications such as mental and motor disorders. With open fractures, inflammatory processes in the lining of the brain often develop. The mortality rate after such injuries reaches 30%.

Delayed consultation with a doctor complicates the child’s condition and can lead to disability or coma. Lack of timely medical care, regardless of the degree of damage to the skull, often ends in the death of the patient. It is necessary to immediately consult a doctor to determine the severity of the injury and prescribe adequate treatment.

Pediatrician of the 2nd category, allergist-immunologist, graduated from the Belarusian State Medical University of the Federal Agency for Health and Social Development. Read more »

Symptoms

Fractures of the parietal bone of the skull are determined by the following characteristics:

• Strong headache;
• possible loss of consciousness;
• development of hematomas;
• the formation of wounds and abrasions in the injured area.

With more serious injuries of this type, the above symptoms are also accompanied by hemorrhage from the eyes, ears and nose. Blood can be seen flowing down the wall of the larynx. Such signs arise due to the fact that the dura mater of the brain is damaged at the junction of the bones. Bruising can also form in the eyeball.

Treatment of infants with parietal bone fractures

After the doctor arrived and diagnosed a “skull fracture in an infant,” the victim must be hospitalized. The choice of treatment tactics will depend on the severity of the injury and the condition of the injured infant. For mild severity, it is advisable to prescribe conservative treatment methods (no stressful situations, rest, strict bed rest).

If a secondary bacterial infection has been identified, the doctor should prescribe antibiotics to avoid complications such as septic shock (the virus will enter the blood). Possible death. If the victim’s condition is moderate or severe, there is no point in treating with conservative methods. Surgery is prescribed.

Surgical operations are also indicated for complications of the underlying disease (bleeding, cerebrospinal fluid, bacterial infection, etc.) After the operation is performed, the patient needs complete rest and strict bed rest until the condition begins to improve (limitation of physical activity). and psycho-emotional stress.)

Treatment of pathology

Therapy is carried out using several methods. Initially, the patient is given an anesthetic drug. The medicine relieves pain. The child gradually calms down.

After receiving the images, doctors prescribe treatment. For closed linear fractures, prolonged rest and cooling are recommended. A cooling pack is applied to the damaged area. It is fixed for 10–15 minutes. The procedure is carried out every three hours.

For open and comminuted fractures of the crown, the patient needs surgical intervention. The operation is called craniotomy. In children, healing occurs in 21 days. On the tenth day, the operated area is covered with thin cartilage tissue.

At a young age, children are active. This leads to various health problems. To avoid fractures and abrasions, it is necessary to closely monitor the child’s actions.

Prevention

Skull injuries in children often occur due to parental inattention. In a newborn child up to one year old, a similar injury can occur during the period when he begins to independently roll over onto his side. At this time, under no circumstances should children be left alone on the sofa or bed, as they may roll onto the edge of the sofa or bed and then fall head down.

To prevent children from injuring themselves, you should pay attention to the following things:

• constant supervision of the child;
• correct behavior of preschoolers near the roadway;
• compliance with safety rules during walks and active games;
• careful behavior with a baby in your arms.

Preventative measures do not require much effort, but they can protect children from unwanted injuries that not only require long-term treatment, but can also leave an imprint for life. Parents must constantly ensure that their child does not hit his head anywhere, but also that he does not fall from a chair, bed or stairs. A fall usually results in a strong blow to the head, which can result in a fracture of the occipital bone or other area of ​​the skull.

The consequences of such an injury may not appear immediately, but years after the injury, and in order to prevent them, it is important to undergo a mandatory course of treatment with strict adherence to all recommendations of specialists

Therapy for a young patient

Based on the child’s diagnosis and general history, the doctor selects individual treatment. A childhood fracture is treated in two ways:

1. Conservative;
2. Surgical.

Conservative therapy

Conservative therapy: closed reposition of bones, if the fracture is displaced, and application of plaster. Non-surgical reduction is performed in simple cases and is performed without anesthesia. Conservative therapy is suitable for simple injuries or for the “greenstick” type of fracture: foot, ankle, ankle, fingers, forearm.

To relieve pain, the child is prescribed analgesics. The pain symptom goes away on the second or third day after fixation. Anti-inflammatory drugs will help prevent complications.

And to speed up the fusion process, the child is prescribed vitamins with a high calcium content.

Surgical intervention

Surgical intervention for a child is prescribed in the most severe cases. Reposition of bone fragments by surgical intervention is divided into types:

• Closed operation. Mainly prescribed for intra-articular injury. The bones are fixed using metal pins that are inserted into drilled holes. The ends of the spokes remain outside, and the fasteners are removed after fusion of the bone tissue;
• Open surgery. Prescribed in case of a fracture with multiple fragments and displacement in the area of ​​the epiphysis, inside the joints. The soft tissues are dissected, the vessels are moved to the side. The bone is fixed using metal plates. The soft tissues are sutured, the limb is fixed with plaster.

All operations on the child are performed under gentle anesthesia. The plaster cast lasts for at least 1 month. Bone tissue restoration is monitored by x-rays, which are taken every 1.5 to 2 weeks.

A child’s tissues grow together quickly, this is due to the following factors:

• The child's body intensively produces collagen, which is necessary for the formation of callus;
• With a greenstick fracture, blood circulation and nutrition of the bone tissue are preserved.

A fracture is dangerous in children aged 10–11 years. At this time, bones grow rapidly and a fracture can provoke different growth of fragments of one link. Variation in bone size is prevented using a bayonet-shaped connection, which is performed through open surgery.

Any, even the most minor childhood fracture, needs treatment. Improper fusion leads to recurrent fractures and the subsequent development of bone tissue pathologies.