Physiotherapy

Difference between bone fissure and bone fracture

Difference between bone fissure and bone fracture

FRACTURE OR BONE FISSURE? HOW TO TELL THE DIFFERENCE AND TREAT PAIN

When we suffer a trauma that affects the bone, we may be diagnosed with a crack or fracture. They can also appear due to repetitive stress, as in the case of stress fractures. Since the symptoms can be similar, there is often confusion between the two injuries, so it is necessary to resort to imaging tests for an accurate diagnosis.

In this article, we will analyze the differences between fissure and fracture, as well as the treatments available from physiotherapy, with special attention to the options for pain management.

BONE AND ITS STRUCTURE

Bone is a living tissue composed of minerals (calcium carbonate and phosphate), water, collagen and proteins. Thanks to these elements, it possesses strength and elasticity. It is divided into:

  • Cortical bone: The outer layer, dense and strong.
  • Trabecular or cancellous bone: Internal, with a cellular structure that favors shock absorption.

Its regeneration depends on the activity of different bone cells (osteoblasts, osteocytes, osteoclasts), whose balance is essential for optimal bone quality.

HOW TO DIFFERENTIATE A CRACK FROM A FRACTURE?

To determine the extent of the lesion, an imaging test is necessary, with radiography being the first option. In some cases, additional studies such as magnetic resonance imaging (MRI) or computed tomography (CT) are required.

Key differences:

  • Fissure: There is no total loss of bone continuity, i.e. the bone is not completely broken or displaced. It resembles a “crack” in the bone.
  • Fracture: It may be displaced (when the bone fragments separate) or non-displaced. In severe cases, it may require manual or surgical reduction and subsequent immobilization.

COMMON SYMPTOMS

Both cracks and fractures can occur:

  • Intense pain.
  • Inflammation and hematoma.
  • Loss of mobility.
  • Tingling sensation or numbness.

PAIN TREATMENT AND MANAGEMENT

Physiotherapy in fissures and fractures

Physiotherapeutic treatment seeks to reduce pain, minimize inflammation and improve function. In the case of fissures, it is started earlier, since total immobilization may cause joint stiffness, muscle retraction and decreased blood flow. In fractures, physiotherapy begins after the immobilization phase.

Conventional therapies:
  • Magnetotherapy: Accelerates bone consolidation.
  • Ultrasound and laser: reduce inflammation and stimulate regeneration.
  • Electroanalgesia: Pain relief by means of low frequency currents.
  • Manual therapy and mobilizations: They prevent stiffness and improve mobility.
Advanced physiotherapy for pain and recovery
  • INDIBA (radiofrequency): Improves edema reabsorption and joint mobility.
  • Percutaneous neuromodulation (PNM): Application of low-frequency currents to affected nerves to reduce pain and improve musculoskeletal function.
  • EPI or MicroEPI: Aimed at soft parts affected by immobilization, surgery or the trauma itself.
Interventional pain treatment and regenerative therapy
  • Infiltrations with corticosteroids or local anesthetics: For pain control in cases of severe inflammation.
  • Nerve blocks: Application of anesthesia to specific nerves to relieve chronic pain.
  • Platelet Rich Plasma (PRP): Regenerative therapy that stimulates bone and soft tissue repair through growth factors.
  • Mesenchymal stem cells: Application in bone and musculoskeletal injuries to promote regeneration.

FINAL PHASE: PHYSICAL READAPTATION

Regardless of the type of injury, the last phase of treatment focuses on physical rehabilitation to correct dysfunctions or compensations generated during recovery. Using a surface EMG analysis, the physical therapist designs an individualized exercise plan to restore strength, mobility and stability to the affected segment.

CONCLUSION

Both fissures and fractures require a proper approach to ensure optimal recovery. Physiotherapy plays a key role in rehabilitation, not only by accelerating bone healing, but also by minimizing pain and improving the patient’s functionality. Thanks to the combination of conventional, interventional and regenerative techniques, it is possible to shorten recovery times and improve quality of life after a bone injury.