Which fracture type is most common in pediatric patients and involves the periosteum?

• A. Buckle Fracture
• B. Greenstick Fracture
• C. Comminuted Fracture
• D. Spiral Fracture

Answer: (A)

In children, bones are more flexible and the periosteum is thicker, so a bending or compressive force often causes the cortex to buckle rather than break completely. This buckling fracture is the most common pediatric injury and it involves only a partial, incomplete disruption of the cortex while the periosteum largely remains intact, allowing rapid healing with simple immobilization.

Greenstick fractures are also pediatric and involve the periosteum, but they feature a partial fracture with bending on the opposite side and a torn periosteum on the tension side, making them less common overall than buckle fractures. Comminuted fractures and spiral fractures come from higher-energy or torsional forces and are not as typical in kids as buckle fractures.