Greenstick fractures Greenstick fractures of the forearm, like complete fractures, have a tendency to displace if not properly immobilized The distal fragment is angulated posteriorly in most greenstick and complete fractures of the distal forearm Angulation of greater than 10 to 15 degrees is an indication for urgent orthopedic referral When there is no significant angulation or displacement of greenstick and complete radial and ulnar fractures, immobilization in a neutral position with either a long arm posterior splint or a sugar-tong splint with orthopedic follow-up within to days is adequate emergency management Salter–Harris fractures Salter–Harris types I and II injuries of the distal radial physis are common injuries among children to 12 years old, and rarely lead to growth disturbance The risk of growth disturbance increases with repeated and delayed manipulations Clinicians should be prepared to make the presumptive diagnosis of a Salter–Harris type I injury when there is point tenderness on the physical examination corresponding to swelling over the distal radius on the radiograph, even when there is no obvious displacement of the epiphysis Orthopedic consultation for closed reduction is indicated for all displaced and angulated physeal fractures, while immobilization and orthopedic referral are recommended for nondisplaced fractures of this type