Greenstick Research Articles

Distal Radioulnar Synostosis Following Greenstick Fracture of the Ulnar Diaphysis

Case: We discuss a 16-year-old adolescent boy presenting with a minimally displaced greenstick fracture of the distal third ulnar diaphysis sustained during a fall playing football. Initial treatment consisted of in situ casting followed by removable forearm splinting. The patient returned 3 months postinjury with complete forearm motion loss. Imaging demonstrated a post-traumatic radioulnar synostosis. Surgical management of the synostosis restored forearm motion without recurrence. Conclusion: Clinicians should be aware of this atypical presentation of a radioulnar synostosis when evaluating stiffness in the post-treatment setting even for fractures that are minimally displaced and do not require reduction or surgery.

Greenstick fractures of the forearm shaft-Is it obligatory or facultative to break the cortex?

To break or not to break-That is the question that has been asked in pediatric traumatology for many years regarding the treatment of greenstick fractures of the diaphyseal forearm shaft. The frequency of greenstick fractures of the forearm shaft in children and adolescents; the influence of breaking the fracture on the refracture rate. Analysis and discussion of relevant articles, analysis of the refracture rate of pediatric greenstick fractures of the forearm shaft in our own patient population. Greenstick fractures frequently occur in the area of the forearm shaft and incomplete consolidation leads to an increased refracture rate. In the patient collective of the authors of 420 children with greenstick fractures of the diaphyseal forearm, there was arefracture rate of 9.5%; however, the rate for non-completed fractures was significantly higher compared to the group with completed fractures (15.2% vs.3%). While in the subgroup of conservatively treated fractures (n = 234), breaking the intact cortex significantly reduced the refracture rate, breaking the intact cortical bone during surgical treatment with elastic stable intramedullary nailing (ESIN) did not change the refracture rate. As part of the conservative treatment of greenstick fractures of the diaphyseal forearm, completing the fracture can be recommended in order to lower the refracture rate. Completing the fracture does not appear to be necessary during surgical treatment using ESIN.

Mechanical characterization of soft-tissue stiffness during mandibular distraction

The purpose of this study was to determine the stiffness of mandibular soft tissues during mandibular distraction, from the perspective of improving distraction devices such as automated continuous distractors.Uncompleted osteotomy was performed on 11 fresh human hemimandibles via a greenstick fracture, to preserve the uplift of the internal periosteum of the mandibular corpus. In order to replicate continuous distraction, direct measurements were performed through a uniaxial quasi-static tensile test. For all specimens, linear regression was applied to the force-displacement curve for a force region of 10–20 N, and the slope extracted. The mean stiffness was estimated to be 9.12 ± 3.56 N/mm.This study is the first to measure directly the stiffness of the surrounding tissues of the human mandibular corpus, and paves the way to the design of a new generation of distractor devices.

Blue pill or red pill? Green, thanks. Behavioural test on coloured light preference in the Calabrian Alpine newt to increase the capture rate

Abstract To improve monitoring techniques, we investigated the colour vision of the Calabrian Alpine newt (Ichthyosaura alpestris inexpectata). We conducted controlled behavioural experiments on male and female newts to explore their response to artificial coloured light sources in the dark. We used green, blue, and orange glow sticks. Observations indicated that both sexes strongly preferred green glow sticks, which were selected in almost 50% of the trials Additionally, newts exhibited markedly swifter reactions to green light. The attraction to green glow sticks may be due to the biofluorescence within the green wavelength spectrum in this newt. This glowing ability, which resembles the green glow stick’s glow, could be beneficial in low-light conditions to locate other newts. Our results show that the behavioural preferences towards a particular light source can significantly enhance the success of capturing newts during population monitoring and conservation efforts for this rare and threatened taxon.

MOST COMMON RADIOLOGICAL FEATURES IN GREENSTICK FRACTURE: AN INTEGRATIVE REVIEW

Objectives: To address, through a literature review, the importance of radiological and tomographic findings in cases of greenstick fracture. Methodology: This is a literature review work in which the Pubmed, Scielo and BVS database was used, addressing the characteristics in radiological examinations in the area of ​​medicine in general, in patients affected by greenstick fracture, using the keywords “Fracture”, “Tomography”, “Distal third”. Results: 10 significant publications were found. The analysis occurred through analytical and interpretative readings. It was found that diagnostic imaging methods are an important part of managing patients with major fractures. Final considerations: Imaging exams were highlighted as relevant for the management of this pathology and the lack of clinical imaging findings in the literature, which justifies the importance of further studies on the subject.

Therapeutic approaches of diametaphyseal radius fractures in children.

There are clear standards for when to operate on both distal epiphyseal and diaphyseal forearm fractures in children. However, paediatric surgeons are often faced with fractures in the transition zone between metaphysis and diaphysis. This aim of the study is to compare different treatment approaches for diametaphyseal forearm fractures, to classify different types of these fractures, and to define further assessment parameters and treatment recommendations. This retrospective study included all patients with diametaphyseal radial fractures who were seen at a paediatric surgery clinic between 01.01.2010 and 31.12.2013. Patients were treated either non-surgically (C) or surgically using bicortical Kirschner wire (BC-KW), intramedullary K-wire (IM-KW), elastic stable intramedullary nailing (ESIN), or combined bicortical and intramedullary K-wire (BCIM-KW). During the study period, 547 patients presented with forearm fractures of which 88 patients (16%) had a fracture in the diametaphyseal region. The majority of diametaphyseal fractures were greenstick fractures (54.4%) followed by transverse fractures (44.3%). Distal fractures were predominantly treated with bicortical K-wiring (BC-KW, 40.5%) or non-surgically (C, 26.2%). Proximal fractures were treated by ESIN osteosynthesis (50%), followed by IM-KW (30%). Intermediate fractures were just as likely to be treated with one out of the 5 above-mentioned techniques. The ulna was involved in 64 of 88 cases. Depending on the type of fracture, it was treated either by ESIN osteosynthesis or non-surgically. No superior operative technique was identified. The description of diametaphyseal fractures as a separate entity is important, because the therapy of these fractures is heterogeneous and challenging. A classification into proximal, intermediate, and distal may be useful in clinical decision-making. Despite the retrospective nature of this study, our data suggest that the use of a K-wire or combined technique BCIM-KW-technique, whenever technically feasible, achieves better radiological results without secondary dislocation. Further prospective studies are needed to provide better guidance to trauma surgeons.

Direct discharge for children with a greenstick or torus fracture of the wrist is a non-inferior satisfactory solution to traditional treatment.

Direct Discharge protocols (DD) can alleviate strain on healthcare systems by reducing routine outpatient follow-up. These protocols include low-complex musculoskeletal injuries, such as isolated greenstick fractures or torus fractures of the wrist in children. While there is consensus on the effectiveness of DD, there is a lack of injury-specific powered studies. This study compares treatment satisfaction between DD and traditional treatment in children with a greenstick fracture or torus fractures of the wrist. Children with isolated torus or greenstick fractures of the distal radius or ulna were eligible for inclusion before (pre-DD cohort) and after (DD cohort) the implementation of DD in four hospitals. Traditionally, patients receive a (soft) cast and minimally one routine outpatient follow-up appointment. With DD, patients are discharged directly from the ED after receiving a brace and information, summarized in a smartphone app and a helpline for questions during recovery. The primary outcome was patient or proxy treatment satisfaction (0 to 10), and a power analysis was performed to assess non-inferiority. Secondary outcomes included complications, functional outcomes measured in Patient-Reported Outcomes Measurement Information System Upper Extremity (PROMIS UE), primary healthcare utilisation, and secondary healthcare utilisation (follow-up appointments and imaging). In total, 274 consecutive children were included to analyse the primary endpoint. Of these, 160 (58%) were male with a median age of 11years (IQR 8 to 12). Pre-DD and DD treatment satisfaction did not vary statistically significantly for greenstick fractures (p = 0.09) and torus fractures (p = 0.93). No complications were observed. PROMIS UE showed no statistically significant differences before and after implementation of direct discharge protocol for torus (p = 0.99) or greenstick (p = 0.45) fractures. Secondary healthcare utilisation regarding follow-up was significantly lower in the DD-torus cohort compared to the pre-DD torus cohort, with a mean difference (MD) of -1.00 follow-up appointments (95% Confidence Interval (CI) -0.92 to -1.13). Similar results were found in the pre DD-greenstick cohort compared to the pre-DD-greenstick cohort (MD): -1.17 follow-up appointments, 95% CI -1.09 to -1.26). Direct Discharge is non-inferior to traditional treatment in terms of treatment satisfaction for paediatric patients with greenstick or torus fractures of the wrist compared to children treated with rigid immobilisation and routine follow-up. Furthermore, the results demonstrate no complications, comparable functional outcomes, and a statistically significant reduction of secondary healthcare utilisation, making DD a good solution to cope with strained resources for children with an isolated greenstick fracture or torus fracture of the wrist.

The use of orthodontics in the management of a bilateral condylar fracture in a child

Mandibular fractures in children are different to those in adults. Greenstick fractures are more commonplace, and displacement less frequently encountered. They are mostly treated conservatively; however, if the occlusion is altered, then reduction will be required. Closed reduction is normally favoured in children because open surgical reduction and internal fixation may impair future growth. Closed reduction is often carried out with arch bars or splints. These may be traumatic and painful for the child. This case report describes the case of a 12-year-old boy who presented with bilateral condylar fractures with displacement and deranged occlusion. Minimal fixed appliance treatment was used to reduce the fractures and restore him to his pre-injury occlusion. CPD/Clinical Relevance: Minimal orthodontic treatment can be used to reduce a bilateral condylar fracture with displacement in paediatric mandibular fractures.

Ultrasonic- and Ultrasound-assisted Improvement of Silhouette of the Torso: Bone Structure High-definition Remodeling (Part I).

High-definition liposculpture allowed plastic surgeons to achieve better aesthetic results by carving the underlying muscles and contours in a new way. Several authors have improved the original technique by adding other procedures and new technologies. We designed a new improvement by incorporating bone transformation surgery to overcome the lack of silhouette at the waist and, as a result, optimize the breast-waist-hip ratios. We carried out a prospective multicenter study, with five different surgeons performing the same rib remodeling technique for waist definition. We used an ultrasonic piece for costal corticotomy and real-time ultrasound imaging to perform green-stick fractures over the last two or three floating ribs. Ours is a new technique based on the prior one described by Kudzaev. We reported 131 consecutive patients who were enrolled in this study. Waistline diameter decreased an average of 8 cm after surgery (P < 0.05). Most patients were women (n = 125, 95.4%). No major complications were reported. Most common complication was prolonged pain, with only three cases of contour asymmetry, all of which were attributable to noncompliance of constantly wearing the corset + compressive garments. Patients reported a high satisfaction rate and fast recovery (Body-QoL survey). Ultrasonic- and ultrasound- assisted indentation surgery of the thorax is a safe and reliable technique for waistline definition, with a high satisfaction rate, almost-invisible scars, and minimal risk for complications. Incorporation of high-definition liposculpture to rib remodeling opens up a new horizon for bone structure modification surgery (S-high-definition remodeling) that can be safely performed for patients who seek better aesthetic outcomes in body contouring.

Management of Greenstick Fracture at the Root of Adult Zygomatic Arch.

Greenstick fractures mostly occur in children and rarely in adults. In adult zygomaticomaxillary complex fractures, the greenstick fracture at the root of the zygomatic arch is occasionally encountered. This makes it difficult to move the fracture segment. Therefore, achieving anatomic reduction is very difficult. Our preoperative 3D repaired model shows that if only the maxilla and zygomatic bones are restored, the patient's face will still have depression and protrusion. The greenstick fracture segment at the root of the zygomatic arch needs to undergo osteotomy to achieve anatomic reduction and restore facial symmetry. The patient's facial appearance was restored after the surgery. The postoperative computed tomography scan showed good alignment of the fracture. The authors believe that a fracture at the root of the zygomatic arch can serve as an indication for open reduction and fixation.

A Simulation Model for the Handheld Ultrasound Diagnosis of Pediatric Forearm Fractures.

Handheld ultrasound (HHU) devices have gained prominence in emergency care settings and post-graduate training, but their application in the diagnosis of pediatric fractures remains under-explored. The aim of this study is to evaluate the effectiveness and accuracy of an HHU device for diagnosing pediatric forearm fractures using a simulation model. The materials for the basic pediatric fracture model include turkey bones soaked in white vinegar to make them pliable, food-grade gelatine, and plastic containers. Ultrasound analysis of the models was done with an HHU device, Sonosite İViz US (FUJIFILM Sonosite, Inc.; Bothell, Washington USA). Four different fracture patterns (transverse fracture, oblique fracture, greenstick fracture, and a torus fracture) and one model without fracture were used in this study. Twenty-six Emergency Medicine residents sonographically evaluated different bone models in order to define the presence and absence of fracture and the fracture subtype. The participants' ability to obtain adequate images and the time taken to create and recognize the images were evaluated and recorded. After the sonographic examination, the residents were also asked for their opinion on the model as a teaching tool. All participants (100%) recognized the normal bone model and the fracture, regardless of the fracture type. The consistency analysis between the practitioners indicated a substantial agreement (weighted kappa value of 0.707). The duration to identify the target pathology in fracture models was significantly longer for the greenstick fracture (78.57 [SD = 30.45] seconds) model compared to other models. The majority of participants (92.3%) agreed that the model used would be a useful teaching tool for learning ultrasound diagnosis of pediatric forearm fractures. All participants successfully identified both the normal bone model and the presence of fractures, irrespective of the fracture type. Significantly, the identification of the greenstick fracture took longer compared to other fracture types. Moreover, the majority of participants acknowledged the model's utility as a teaching tool for learning ultrasound diagnosis of pediatric forearm fractures.

Current Trends In Complete Denture Education In Undergraduate Dental Colleges Of Pakistan.

To determine the current trends in complete denture education in undergraduate dental colleges. The survey-based study was conducted in April and May 2020 at undergraduate dental colleges of Pakistan, and comprised heads of the Prosthodontics Department at all dental colleges across Pakistan having at least one batch of final year dental students. Data was collected using an online predesigned questionnaire that explored theoretical and practical teaching patterns of complete denture prosthodontics in the undergraduate years, and the materials and practices of students when constructing complete dentures in the clinics. The participants were given the option of choosing more than one option where needed. Data was analysed using SPSS 23. Of the 49 subjects approached, 40(81.6%) returned the forms duly filled; 11(27.5%) from public-sector institutions and 29(72.5%) from the private sector. There were 26(65%) institutions which required that their undergraduate students fabricate 2-4 conventional complete dentures. In all 40(100%) colleges, faculty gave live clinical demonstrations before students fabricated conventional complete dentures in the outpatient departments. Teaching strategy included small group discussions in 25(62.5%) institutions. Green stick 40(100%), zinc oxide eugenol 40(100%) and impression compound 39(97.2%) were the materials of choice for various steps of impression making. In all the 40(100%) institutions, students fabricated conventional complete dentures during their prosthodontics rotation. Immediate, copy and overdentures were constructed by students in 8(20%), 3(7.5%) and 8(20%) institutions, respectively. Majority of the dental schools used similar impression materials and techniques for fabricating conventional complete dentures. Didactic teaching of conventional and unconventional complete dentures was being carried out at a huge majority of the dental institutions studied.

Possibility of Avoiding Anesthesia in the Reduction of Greenstick and Angulated Forearm and Distal-End Radius Fractures in Children: A Comparative Study.

Introduction Greenstick and angulated forearm bone fractures are the most common fractures in children and invariably require closed reduction under anesthesia. However, pediatric anesthesia is somewhat risky and not always available in developing countries like India. Therefore, this study aimed to evaluate the standard (quality) of closed reduction without anesthesia in children and to determine satisfaction among parents. Materials and methods The present study included 163 children with closedangulated fractures of the distal radius andfracture shafts of both forearm bones, who were treated by closed reduction. One hundred and thirteen were treated without any anesthesia (study group) on an outpatient department (OPD) basis, whereas50 children of similar age and fracture type underwent reduction with anesthesia (control group). After reduction by both methods check X-ray was done to evaluate the quality of the reduction. Results The average age of the 113 children in the present study was 9.5 years (range: 3.5-16.2 years), of which 82 children had radius or ulna fractures, and 31 had isolated distal radius fractures. In 96.8% of children, ≤10° of residual angulation was achieved. Furthermore, 11 children (12.4%) used paracetamol or ibuprofen for pain control in the study group. Moreover, 97.3% of parents stated that they would like their children to be treated without anesthesia if any fracture occurred again. Conclusions Closed reduction of greenstick angulated forearm and distal-end radius fracture in children in the OPD without anesthesia achieved satisfactory reduction and high parent satisfaction while reducing the risks of pediatric anesthesia and its associated complications.

Failure Behavior and Failure Locations of Oxytenanthera Abyssinica Bamboo Culms under Bending Load

Bending failure modes in solid stem wood and solid culm bamboo varies depending on material and geometric properties. Solid culm cross-sections of Oxythenantera Abyssinica round bamboo resemble to wood, but are anatomically different in their mode of growth and tissue organization. The bending stress gradient and failure behavior has highly related with the culm internal voids termed as hollowness which depends on age of bamboo. Hollowness (k) refers the relative proportion of void volume to solid volume with in a culm. Full culm beam specimens with length of 3.5 m were subjected to bending under 4-point static loading according to ISO 22155. Pattern of vertical deflection varies depending on the maturity of the culm. A statistical and experimental results showed that, for K values between 12-15% a mixed mode of local buckling with a longitudinal shear splitting failure mode was resulted in 4-year age bamboo specimens with a slight (14 mm) shift from the shear center inducing large vertical deflection (142 mm) at midspan. A kink buckle and green stick modes were observed in 2-year and 3-year ages culms at failure point of 124 and 158mm at length ‘L’ (L/2.5 to L/4.5) from shear center with a k value 25-27% and 18-22% respectively.

COMPARATIVE EVALUATION OF THE EFFECT ON THE RETENTION OF MAXILLARY DENTURE BASE BY USING TWO DIFFERENT BORDER MOLDING TECHNIQUES AND TWO DIFFERENT MATERIALS- AN IN VIVO STUDY

Purpose: This study was undertaken to compare the retention between sectional border molding using low fusing greenstick compound and single step border molding using condensation silicone (putty) impression material in two stages- A. After final impression and B. With the temporary denture base. Materials &amp; Methods: In this study evaluation of retentive values of sectional border molding (Group I) (custom impression trays border molded with green stick compound ) and single step border molding (Group II) ( border molding with condensation silicone (putty) impression material ). In both techniques definitive wash impression were made with light body condensation silicone and denture base with auto- polymerization resin. Results: Group 1B was significantly higher (mean- 2.176) than Group 1A (mean- 1.798) in test-1. The t-value (6.023) infers that there was significant difference between Group 1A and Group 1B (p =0.001). Group 2B was significantly higher (mean- 2.344) than Group 2A (mean-2.111) in test -2. The t-value (2.852) infers that there was significant difference between Group 2A and Group 2B (p=0.001). Conclusion: Within the limitations of this clinical study border molding using custom tray with low fusing green stick compound provided significant difference for retention as compared to condensation silicone at border moulding and denture base stage.

The Barn Doors Greenstick Fracture-A New 3D Geometry for Common Osteotomies in Rhinoplasty: The First 50 Patients with 1-Year Follow-up.

The "barn doors greenstick fracture" is a new concept that includes three contiguous greenstick fractures: one in the central compartment of the nasal dorsum (nasal bones) and two on the lateral walls of the bony nasal pyramid. The present study aimed to describe this new concept and to report the first esthetical and functional outcomes. This prospective, interventional, and longitudinal study was performed on 50 consecutive patients undergoing primary rhinoplasty by spare roof technique B. The validated Portuguese version of the Utrecht questionnaire (UQ) for outcome assessment in esthetic rhinoplasty was utilized. Each patient answered the questionnaire online before surgery and 3 and 12 months after surgery. In addition, a visual analog scale (VAS) was used to score nasal patency for both sides. The patients also answered three questions (yes or no): (1) "Do you feel any step on your nasal dorsum?" if yes: (2) "Is that step visible?" (3) "Does it bother you?"A statistically significant improvement in UQ scores postsurgery was found, demonstrating a high satisfaction index in this patient population. Additionally, the preoperative and postoperative mean functional VAS scores showed a significant and consistent improvement on both sides (right and left). Twelve months after surgery, a step at the nasal dorsum was felt by 10% of the patients, but it was visible just in 4%, which were two females with thin skin.The barn doors greenstick concept provides a new approach to achieve a real and sustainable smooth transition in the dorsal and lateral walls. The association of the two lateral greensticks and the already described subdorsal osteotomy allows a real greenstick segment in the most critical esthetic region of the bony vault-the root of the nasal pyramid.

Return to sport after forearm fractures in children: A scoping review and survey.

A common question faced by clinicians is when a child may return to sport after treatment for a pediatric forearm fracture. There are few published recommendations and fewer supported by evidence. The aims of this study were to summarize existing published recommendation for return to sport after pediatric forearm fractures and to conduct a survey to determine usual clinical recommendations. A scoping review was performed on Ovid MEDLINE, Cochrane Central Register of Controlled Trials, Embase, Scopus, and Google Scholar in accordance with the Joanna Briggs Institute guidelines. In addition, 64 orthopedic surgeons were anonymously surveyed asking for recommendations regarding return to sport after pediatric forearm fractures. Participants were to assume children were 9 years old and played a sport with an average risk of forearm injury. Twenty-two publications for return to sport were retrieved. Children with distal radius buckle fractures safely commonly returned to sport by 4 weeks after initial injury, while survey respondents recommended over 6 weeks. Survey respondents valued fracture stability the highest when making return to sport recommendations. Children with simple, metaphyseal, single-bone fractures were usually allowed to return to sport at 8-10 weeks post-injury. Diaphyseal and complete fractures were prescribed longer return to sport intervals. Australian respondents also prescribed longer return to sport intervals. Children with distal radius buckle fractures may return to sport by 4 weeks after initial injury, sooner than recommended. Published recommendations remain limited for other fractures. However, our survey suggests children with simple, metaphyseal, single-bone fractures may return to sport at 8-10 weeks. Children with diaphyseal and complete fractures should abstain from sport for longer than metaphyseal and greenstick fractures, respectively. level V.

Pengolahan Camilan Stick Rumput Laut Hijau (Eucheuma) Berdasarkan Uji Organoleptik pada Murid Sekolah Dasar (SD) Negeri 29 Kendari

Stick snack products are foods that are still rarely found in the community. Green seaweed plants contain carbohydrates, protein, fat, most of which are salt, sodium, and potassium compounds. beta-carotene and minerals. This study aims to determine the acceptability of color, texture, aroma and taste of green seaweed stick snacks with the addition of wheat flour in school children at SDN 29 Kendari. The type of research used is descriptive. The panelists were 53 students of SD Negeri 29 Kendari. The sampling technique used is the saturated survey. The data obtained using observation sheets and analyzed descriptively. The result of color preference for green seaweed stick snack products, namely R4 has the best acceptance rate of 90.6%. From the aspect of texture, that is R4 as much as 89.2%. From the aspect of aroma, namely R4 as much as 92.5%. Meanwhile, from the taste aspect, R4 is 92.5%. The conclusion of this study is the acceptability of green seaweed stick snacks based on the attributes of color, texture, aroma and taste. Meanwhile, the panelists preferred the R4 product more than other products.

An unusual metatarsal of theropod dinosaur from the lower cretaceous of Thailand: the first detailed study of paleopathology in Megaraptora

ABSTRACT A pathological metatarsal of the early-branching megaraptoran Phuwiangvenator yaemniyomi from the Lower Cretaceous of Thailand is here studied. It was CT-scanned and compared with pathology in other dinosaurs and living animals. The result shows that the palaeopathology in Phuwiangvenator was a traumatic fracture, specifically a greenstick fracture, based on the incomplete breakage of the bone, which occurred only on one side and twisted or distorted in the opposite direction to the force that caused the pathology. The cause of the fracture was possibly by accidentally hitting or kicking hard material, fighting, or falling to the ground. Phuwiangvenator was probably an adolescent when it was injured and survived the incident. This is the second report of a greenstick fracture in Theropoda after Akansaurus fridayii; the first detailed analysis of palaeopathology in Megaraptora; and the first record and detailed description of palaeopathology in non-avian theropods in Southeast Asia.

Maxillary Ridge Split with Simultaneous Implant Placement – A Case Report

Inadequate alveolar ridge width often poses difficulty in implant placement. Such ridges require a combination of techniques in placing implants. One such technique is the ridge split technique which helps the expansion of the ridge with or without greenstick fracture of cortical plates. Before placing implants the width of the alveolar ridge can be effectively restored utilising the modified ridge splitting approach employing autologous bone grafts. This case report describes the ridge splitting and placement of a dental implant in the left maxillary central region followed by guided bone regeneration. Ridge expansion was done in relation to 21 and osteotomy was prepared to the desired depth. After proper treatment planning implant measuring 3.5 mm in diameter and 11.5 mm in length was placed. Four months later final cementation was done with PFM crown. The ridge split technique with the immediate implant placement resulted in minimal resorption of alveolar bone along with maximum expansion of the bone. The sequential surgical and restorative techniques were combined into one successful protocol whose steps are well elaborated in this case report.