A Critical Appraisal of Bhagna (Fracture) and Its Management in Ancient Indian Surgery

Abstract

Fractures are one of the common surgical conditions in the orthopedics and many of the new techniques are developed for the management as per the condition. In ancient Indian surgery Acharya Sushruta described extensively in Sushrutasamhita Nidana and Chikitstastans about fracture, its etiology, classifications and various modalities of management and also termed this condition as Bhagna. In ancient times, Bhagnas were commonly seen in wars or violent attacks by wild animals, etc., but presently these are common due to road traffic accidents. In the classics of Ayurveda the classification of Bhagna was extensively explained based on nature of violence, shape of fracture, displacement of fracture fragments, fracture with or without wound. Further Sushruta explains that if it occurs in the bones it is called as Kandabhagna (bone fracture) and in the joints it is called as Sandhimukta (joint dislocation). Again he sub-classifies Kandabhagna under twelve types and Sandhimukta under six types. Sushruta describes various modalities of fracture management; as per the condition he suggests the conservative or surgical management. Conservative management includes Kushabandhana, Alepa, Chakrayog, Tailadroni, etc. This paper elaborates the wisdom of orthopedic branch in ancient times especially fracture and its management with possible modern co-relates and shows how much knowledge existed and how well organized it was so many centuries ago. The concepts, theories, and techniques practiced several thousand years ago hold true even in today’s practice.

Keywords: Kandbhagna, fracture, ancient Bhagna surgery, Asthibhagna