SUSHRUTA'S TECHNIQUE IN THE MANAGEMENT OF

2
 THE INCIDENCE

⇒ The agricultural sector(194.5per10,000 workers),

⇒ The mining (168.8 per 10,000 workers),

⇒ The construction (111.7 per 10,000 workers)

⇒ The manufacturing (87.5 per 10,000 workers).

⇒ The males had significantly higher incidence rate

than females except for the educational sector.
SUSHRUTA'S TECHNIQUE IN THE MANAGEMENT OF
3
 RESEARCHES
 27 P.G. dissertations From 1966 to 1996,
 1Ph.D. works

棧An approach to human ailments is as old

as the evolution of human being. The most
ancient practiced medical science is
Ayurveda.

棧Orthopedic surgery - Bhagna Chikitsa

SUSHRUTA'S TECHNIQUE IN THE MANAGEMENT OF

4
 ASTHI SHAREERA

Asthi - Stable and Strong.

 Develops during third month of intrauterine

life.

 Pitrujabhava is responsible for the formation

of Asthi.

 Asthivaha srothasa is the channel through

which the nutrients are being circulated
within the asthidhatu.
SUSHRUTA'S TECHNIQUE IN THE MANAGEMENT OF
5


• ASTHI SANKHYA

• ASTHI PRAKARA

• ASTHI KARYA

SUSHRUTA'S TECHNIQUE IN THE MANAGEMENT OF

6
SHABDHOTPATTI
Bhanjayatithibhagna| | (Shabdasthoma )
PARYAYA
Bhagna, Bheda, Bhedana, Bhanjana, Vibhaga.
NIDANA
Patana,Peedana,Praharena,Akshepana,Vyalamruga
dashana, Balavadnigraha, Abhipatanishesha

EFFECT OF TRAUMA ON BONES :

1. Cartilage's Bend
2. Long bones -Break
3. Flat bones - Crack
4. Teeth - Fragmented
5. Curved bones - Crack or Break.
SUSHRUTA'S TECHNIQUE IN THE MANAGEMENT OF
7
 CLASSIFICATION OF BHAGNA

[A] 1) Sandhimukta 2) Kandabhagna. (Sushruta)

[B] 1) Sandhibhagna 2) Asandhibhagna.(Vagbhata)

[C] 1)Savrana bhagna 2) Avrana bhagna.(Madhukosha)

SUSHRUTA'S TECHNIQUE IN THE MANAGEMENT OF

8
 Classification of Kandabhagna
Name of Sushruta Vagbhata Vagbhata Charaka Bhava Madhava Sharang
Bhagna A.H. A.S. Prakasha Nidana adhara
Karkataka + + + --- + + ---
Ashwakarana + + + --- + + ---
Choornita + + + --- Vichoorni Vichoorn ---
ta ita
Picchita + + + --- + + ---
Asthichallita + + + --- + Asthichall ---
ika
Kandabhagna + Vellita Vellita --- + + ---
Majjanugata + + + --- + Majjagata ---
Atipatita + + + --- + + ---
Vakra + + + --- + + ---
Chinna + Shoshita Shoshita --- + + ---
Patita + Darita Darita --- + + ---
Sphutita + + + --- Visphutita + ---
GENERAL FEATURES OF 'KANDABHAGNA'

⇒ Shvyathubahulyam
⇒ Sparshasahisnutvam
⇒ Avapidyamane shabda
⇒ Vividhavedanapradurbhavah
⇒ Sarvasu Avasthasu Na Sharmalabha

SUSHRUTA'S TECHNIQUE IN THE MANAGEMENT 10

OF
SPECIFIC FEATURES OF INDIVUDAL 'KANDABHAGNA'

1)Karkataka -- Depressed Fracture

(2)Ashwakarana - Complete Oblique Fracture
(3) Churnitam-- Comminuted Fracture
(4) Pichhitam- Compressed
Fracture
(5) Asthichallita--Periosteal Avulsion
(6) Kanda bhagna -- Complete Spiral Fracture
(7) Majjanugatam-- Impacted fracture
(8) Atipatitam -- Complete compound fracture
(9) Vakra -- Greenstick Fracture
(10) Chinnam -- Incomplete Fracture
(11) Patitam --Cracked fracture of Flat
Bones
12) Sputita -- Fissured
Fracture
SUSHRUTA'S CLASSIFICATIONWITH NEAREST MODERN
COMPARISON
⇒ Karkataka: Depressed fracture.

⇒ Ashwakarana:Complete oblique fracture.

⇒ Churnitam: Comminuted fracture
⇒ Pichhitam: Fracture by compression.
⇒ Asthichallita : Sub periosteal avulsion.
⇒ Kandabhagna: Complete spiral fracture.
⇒ Majjanugatam: Impacted fracture.
⇒ Atipatitam: Complete compound fracture.
⇒ Vakra : Green stick fracture.
⇒ Chinnam: Incomplete fracture.
⇒ Patitam: Comminuted fracture flat bones.
⇒ Sputita: Fissured fracture.
SUSHRUTA'S TECHNIQUE IN THE MANAGEMENT 23
OF
 PROGNOSIS

S EASONAL VARIATION

STATUS OF
AGE PATIENT

SITE OF STATUS OF
FRACTURE BONE

TYPE OF
FRACTURE

SUSHRUTA'S TECHNIQUE IN THE MANAGEMENT 24

OF
 (1) Local (2) Systemic.

(1) Local complications Malunion

Fragmented Fracture.

Swelling, Due to tight

pain, bandaging
Avascularization
Gangrene

(2) Systemic complications

⇒ Fever,
⇒ Abdominal distension,
⇒ Cessation of passages of excreta

SUSHRUTA'S TECHNIQUE IN THE MANAGEMENT 25

OF
(1) Principles of Bhagna Chikitsa.

(2) General Management of Bhagna.

(3) Specific Management for different types

of fractures.

(4) Medicinal preparations for different

kinds of fractures

(5) Pathyaa-Pathya.

(6) Clinical criteria of fracture healing.

 Four Principles of Treatment

1) Anchana (Traction) 2) Peedana( Manipulation)

3) Sankshepan(Opposition 4)Bandhana(Immobilization)
and stabilization)
SUSHRUTA'S TECHNIQUE IN THE MANAGEMENT 27
OF
 General Treatment of Bhagna.

1) Pariseka 2) Lepana.

Specific Rx for different types of fractures

⇒ Fracture with the wound / compound fracture
Wash with 'Nyagrodhadi gana dravyas'
Honey and Ghee should be applied.
Rest is as in case of general management.
⇒ Phalanx fracture or dislocation,
First set in its natural position
Bandaged with pieces of thin linen
Sprinkled with ghee. Etc.
 Rehabilitation
1) MritapindaDharan 2) LavanaDharana 3) PashanaDharna

SUSHRUTA'S TECHNIQUE IN THE MANAGEMENT 29

OF
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ªd›¦deŸdeI¶£±dd
A¥SddSd.
Ad¬dy§dad¤d‰a
«de¦¡dÝd «d¥dgI¶«dŠ
T™£dŸd¦Q¦da |
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 THE LIST OF DRUGS IN THE MANAGEMENT OF
FRACTURES
1.Gandha Taila 2. Gandhaprasarini Taila
3. Chakrataila 4. BhagnasandhanaTaila
5. BhagnasandhanaVati 6. Laksha Guggulu
7.LashunadiVati, 8.MadhuyasthiKsheerapaka
9. Pravala Panchamruta 10. Rajata Bhasma
Rejuvenators
1. Haritaki 2. Yastimadhu
3. Amalaki 4. Lashuna
5. Pippali 6. Kakoli, Ksheera Kakoli etc..
7. Shilajitu 8. Godhooma
9. Priyangu 10. Kapitha Phala Majja.
Lavana, Katu Rasa, Kshara and Alma article of food
Live on strictest continence,
Over exposure to sun
Physical exercises.

Shali rice, meat soup,

Milk, ghee, soup of pulse and
Nutritive and constructive food and drink,

CLINICAL SIGNS OF IDEALLY UNITED BONE

1) No swelling or hardness on palpation.

2) Absence of shortening and deformity.
3) Painless and easy movements
 MANJ ISTHA

YASHTI MADHU

SUSHRUTA'S TECHNIQUE IN THE MANAGEMENT 33

OF
 SHALI

SHATADHOUTA-GRITHA

SUSHRUTA'S TECHNIQUE IN THE MANAGEMENT 34

OF
 RAKTA CHANDANA

DRUGS USED FOR KSHEERAPAKA

GHRISHTA-KSHEERA

SUSHRUTA'S TECHNIQUE IN THE MANAGEMENT 35

OF
LAKSHA

SUSHRUTA'S TECHNIQUE IN THE MANAGEMENT 36

OF
DRUGS USED FOR THE SPLINTS
UDUMBAR

ASHWATTHA

SUSHRUTA'S TECHNIQUE IN THE MANAGEMENT 37

OF
 PALASHA

VANSHA

,
,

SUSHRUTA'S TECHNIQUE IN THE MANAGEMENT 38

OF
Drugs Used for LEPA
Drugs Rasa Guna Veerya Vipaka
Manjistha Kashaya, Guru Ushna Katu.
Tikta Ruksha
Yesthimadhu Madhura Guru Sheeta Madhura
Raktachandana Madhura Guru Sheeta. Katu
Shalipisti Madhura Snigda Sheeta Madhura
Kashaya
Drugs Used for KSHEERAPAKA
Laksha Kashaya Snigdha Anushna Katu
Laghu
Shatadhautaghrita Madhura Guru Sheeta Madhura
Drugs required for lepa and ksheera paka :
1) Lepa

2) Ksheerapaka
i) Ksheera ii) Yashti madhu iii) Laksha iv) Ghee.
Source of data
Criteria of selection of Patients :
i ) Male or Female

ii) Hospitalized or Ambulant.

iii) Simple or Closed Fractures.

iv) Fractures of Humerus, Radius, Ulna, Femur, Tibia,

Fibula, Metacarpals, Metatarsals, and Phalanges
which can be reduced by closed reduction method
with or without general Anesthesia.

v) Stable fractures i.e. fractures in which the alignment

of bony ends can be maintained without internal fixation.
Criteria of Exclusion of patients :
i) Open or compound fractures.
ii) Simple fractures with wounds were excluded.
iii) Pathological fractures, Stress Fractures, and complicated
fractures.
iv) Fractures requiring open reduction and internal fixation.
v) Fractures associated with other debilitating diseases like
Diabetes, Tuberculosis, Leprosy, Asthma is excluded.
vi) Patients suggestive of Osteomyelitis and other bone
diseases.
vii) Patients above the age of 75 years.
 Trial Procedure
Investigations X- RAY
Laboratory investigations

MANAGEMENT OF FRACTURES IN GROUP -A.

SUSHRUTA'S TECHNIQUE IN THE MANAGEMENT 43

OF
Drug Supply and Dosage: Lakshaksheera Paka was
given 100ml. Daily in the morning.

Ahara : Patient's usual vegetarian and non vegetarian diet

was continued with restrictions of Lavana, Katu, Amla rasa,
Kshara and Ruksha dravyas.

Vihara: Atapa sevana and Vyayama were restricted.

SUSHRUTA'S TECHNIQUE IN THE MANAGEMENT 44
OF
Follow up:
Parameters of assessment
a) Subjective improvement. b) Objective improvement.

RADIOGRAPHS SHOWING HEALING OF BONE

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