Author: Dr. Vikram Chauhan

ABSTRACT

Fractures are one of the most well-known and obliterating wounds around the world. Musculoskeletal injuries affect bones, joints, muscles and tendons. In addition, the neurovascular bundle of the limb may also be damaged. Simply put, a fracture is a disruption of the continuity of the bone. Many people are confused between fracture and dislocation. A broken bone is known as a fracture and when a joint is displaced or exhibited from its normal position is known as dislocation. In this article, we will discuss the different types of fractures, their various causes, symptoms, and treatments.

INTRODUCTION

A fracture may be a complete crack or gap in the continuity between bones. Damage is often caused by pressure or stress. However, people with bone or cancer suffer damage, but less so. Bone is a special type of tissue with unique properties. There are five types: in-length bones, short bones, flat bones, irregular bones and sesamoid bones.

CLASSIFICATION OF FRACTURE

1. Based on etiology

1. Traumatic fracture- fracture caused by road traffic accidents, fights etc.
2. Pathological fracture- a fracture through a bone weakened by metastasis
3. Stress fracture

2. Based on displacements

1. Undisplaced fracture
2. Displaced fracture

3. Because of the relationship with the outside climate

1. Open fracture
2. Closed fracture

4. Based on the complexity of the treatment

1. Simple fracture
2. Complex fracture

5. Based on the pattern

1. Oblique fracture
2. Transverse fracture
3. Spiral fracture
4. Comminuted fracture
5. Segmental fracture
6. Butterfly fracture

CLINICAL FEATURES

1. Pain and swelling
2. Irregularity
3. Deformity
4. Loss of function
5. Tenderness
6. Abnormal mobility

LOCAL EXAMINATION

1. Inspection- Abnormal swelling, Attitude, Shortening, overlying skin.
2. Palpation- tenderness, bony irregularity, abnormal movements, crepitus, swelling, wound, pain elicited by manipulation from a distance
3. Measurement- longitudinal, measurements of the circumference of the limb
4. Movements

INVESTIGATIONS

1. X-rays can confirm whether a person’s bone is broken.
2. A CT scan is used to check your bones for injuries, sores, fractures, or other problems.
3. MRI is best to diagnose stress fractures.

FACTORS INFLUENCING TIME FOR FRACTURE HEALING

1. Age
2. Constitution
3. Fracture type (Site, Configuration)
4. Displacement
5. Soft tissue damage
6. Apposition of fragments
7. Immobilisation

COMPLICATIONS OF FRACTURES

Complications can occur immediately, early or late.

• Immediate complications– Pain, Pallor, Paralysis, Pulseless, Paresthesia
• Early complications- Local (gas gangrene, fracture blisters, venous thrombosis, visceral complications) and General (Fat embolism, Tetanus, Pneumonia)
• Late complications- Local (joint stiffness, malunion, chronic infection, refracture, growth disturbance) and General (Accident neurosis)

AYURVEDIC OVERVIEW OF FRACTURE

The cure for human disease is as old as human evolution. The oldest medicine is Ayurveda. In Ayurveda, the fracture is correlated with ‘Bhagan’. According to Acharya Sushruta, they classified the Bhagna into two types: Kanda Bhagna (fracture) and Sandhimoksa (Dislocation). Here we will discuss Kanda Bhagna (Fractures).

NIDANA (ETIOLOGY)

पतनपीडनप्रहाराक्षेपणव्यालमृगदशनप्रभृतिभिरभिघातविशेषेैरनेकविधमस्थनाम् भग्नमुपदिशन्ति ।। (Su. Ni. 15/3)

1. Patan (Fall from somewhere)
2. Peedan (compression)
3. Parhar (strike with a stick)
4. Aakshepan (Pulling)
5. Vyal (trauma)

KANDA BHAGNA

काण्डभग्नमत ऊर्ध्वं वक्ष्यामः – कर्कटकं, अश्वकर्णं, चूर्णितं, पिच्चितं, अस्थिच्छल्लितं काण्डभग्नं, मज्जानुगतं, अतिपातितं, वक्रं, छिन्नम्, पाटितम्  स्फुटितमिति द्वादशविधम् ।। (Su. Ni. 15/8)

Karkataka (Tranverse fracture), Aswakarna (Oblique fracture), Choornitha (Comminuted fracture), Pichitha (Compression fracture), Asthichallitha (Longitudinal fracture), Kandabhagna (Transverse fracture), Majjanugata (Impact fracture), Athipathita (Comminuted fracture), Vakra (Greenstick fracture), Chinna (incomplete fracture), Patitha (Cracked fracture), and Sputitha (Fissured fracture ).

LAKSHANA (Signs of Kanda Bhagan)

1. Shotha (swelling)
2. Sapandan (Pulsation)
3. Vivartan (Rotation)
4. Vivida vedana (Pain of various types)
5. No relief in any condition

MANAGEMENT BY ACHARYA SUSHRUTA

Diet for fracture patient

लवणम् कटुकं क्षारम्लम् मैथुनमातपम् । च न सेवेत भग्नो रुक्शान्नमेव च ।। (su. chi. 3/4)

Salty, bitter, alkaline, acidic, sexual intercourse, sunlight, exercise and dry food should not be consumed by the patient of Bhagan. A person suffering from Bhagan should consume meat, milk, drink, pea yush (a liquid preparation ), and a brimhana diet (which nourishes the depleted body components). The milk of the first delivery cow,  Laksha powder mixed with ghee should be given to the patient of Bhagan in the morning.

Bhaganrohan avadhi (Time for fracture union)

A person with childhood and minor defects and on proper treatment in the winter season can be cured easily. The fracture of childhood becomes stable in one month, the fracture of youth in two months, and that of old age in three months.

HERBAL REMEDIES FOR FRACTURE HEALING BY PLANET AYURVEDA

Planet Ayurveda offers the best combination of amazing herbal medicines, such as the FRACTURE HEALING PACK. These are 100% pure and natural herbs. The Fracture Healing Pack includes

1. LAKSHADI GUGGUL
2. CISSUS POWER CAPSULES
3. ASHWAGANDHADI GHRIT
4. BONE SUPPORT
5. DASHMOOLA CAPSULES

PRODUCTS DESCRIPTION

1. LAKSHADI GUGGUL

Lakshadi guggul is a classical preparation in which one of the ingredients is Laksha (Laccifer lacca). It also contains Guggul (Commiphora mukul) and Ashwagandha (Withania somnifera). Both of these help increase Vata’s energy and are also good for pain relief. Due to all the trauma in the body, the Vata energy in the body is heavy and causes pain and swelling. The formula also contains Arjuna (Terminalia arjuna) to help improve blood circulation. It is also a good source of calcium, which helps improve the healing process. The formulation helps to soothe ligaments and helps strengthen bones due to the presence of Asti Shrinkhala/Hadjod (Cissus quadrangularis). It contains Nagabala (Grewia populifolia) which possesses anti-osteoporotic effects and is useful in the management of low BMD (Bone Mineral Density).

Dosage: Two or three times a day, 1-2 tablets each time, with lukewarm water

2. CISSUS POWER CAPSULES

Cissus power is a very powerful herb that is unique in Ayurveda in supporting the entire skeletal system of the body. Cissus power has a single component called the Hadjod (Cissus quadrangularis). Known for its pain-relieving properties, this herb also helps speed up the bone healing process. Asthi Shrinkhala means that it helps to maintain the relationship between Asthi dhatu. This herb is also good for shrinking bones. The plant is mild and easy to digest, sweet in taste, sharp after chewing, has hot potency and balances Vata and Kapha energy.

Dosage: Require 1-2 tablets two times every day, after meals with water.

3. ASHWAGANDHADI GHRIT

Ashwagandhadi ghrit is an excellent preparation of ghrit which is effective in reducing fatigue (mainly due to pain) in this case. Additionally, there are Bibhitaki (Terminalia bellirica)  and Ashwagandha (Withania somnifera) as components of ghrita. Bibhitaki helps heal broken bones, thus speeding up the healing process. It also includes Cow’s milk and Cow’s ghee, so it acts as a vata dosha pacifier. This formula supports overall health and nourishes tissues, joints and nerves.

Dosage: As guided by the physician or take 3 to 6 grams of Ashwagandhadi ghrita mixed with mishri.

4. BONE SUPPORT

Bone Support Formula is a great blend of herbs that work well for broken bones. The herbs in this formula help reduce symptoms such as tingling and surrounding swelling. In addition, this formulation helps strengthen the cartilage. Asthi bhagan can aggravate the vata dosha, causing joint pain and sometimes crepitation. Bone boosters have Hadjod (Cissus quadrangularis), which helps increase bone density, and Arjun (Terminalia arjuna), which helps improve blood flow. Apart from this, it also contains Praval pishti (Corallium rubrum) and Mukta (Compound of Pearl Calcium), which help to increase the calcium in the body.

Dosage: With plain water, after meals. 1 capsule two times a day.

4. DASHMOOLA CAPSULES

The Dashmoola herbal medicine contains ten herbs that are very good for calming energy. Dashmool means using the roots of 10 herbs and the special roots of 10 different plants to prepare the capsules. It contains herbs such as Bilwa (Aegle marmelos), Shyonak (Oroxylum indicum), Patla (Stereospermum suaveolens), Agnimantha (Clerodendrum phlomidis), Gambhari (Gmelina arborea), Gokshura (Tribulus terrestris), Kantakari (Solanum surattense), Brihati (Solanum indicum), Prishnaparni (Uraria picta), and Shalparni (Desmodium gangeticum). This capsule is very effective in calming the vata dosha, thus reducing pain. Bilwa is used in fractures for wound healing. Shyonak is used as a antiseptic. Patla is used for its anti-inflammatory properties. Agnimantha is useful in cases of swelling and inflammation. Gambhari is useful to reduce pain and also treats Vata and Pitta diseases. Gokshur is a pain reliever and is used for inflammation. Kantakari manages pain and inflammation. Shalparni has an antipyretic property.

Dosage: – Take 1-2 tablets twice a day, after meals with plain water.

CONCLUSION

Fractures can range from minor cracks to complete fractures and can occur in any bone. Conditions such as physical trauma, overuse, and osteoporosis are common causes of fractures. Additionally, a person’s bones tend to weaken after aging. This increases their risk of fracture. The body can heal most broken bones, but treatment usually involves keeping the broken bone in place. Planet Ayurveda has a combined package called the FRACTURE HEALING PACK. It can be easily purchased from the Planet Ayurveda store. Also, follow the nutritional guidelines listed above for best results.