Fracture Ayurveda Managaement(Bhagna)
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Transcript of Fracture Ayurveda Managaement(Bhagna)
SUSHRUTA'S TECHNIQUE IN THE MANAGEMENT OF AVRA NAKANDABHAGNA
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3SUSHRUTA'S TECHNIQUE IN THE MANAGEMENT OF AVRA NAKANDABHAGNA
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.
4SUSHRUTA'S TECHNIQUE IN THE MANAGEMENT OF AVRA NAKANDABHAGNA
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 AVRA NAKANDABHAGNA
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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.
Medasa and Jaghana are the moola of asthivaha srotasa.
SUSHRUTA'S TECHNIQUE IN THE MANAGEMENT OF AVRA NAKANDABHAGNA
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ASTHI SANKHYA
ASTHI PRAKARA
ASTHI KARYA
SUSHRUTA'S TECHNIQUE IN THE MANAGEMENT OF AVRA NAKANDABHAGNA
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SHABDHOTPATTI
Bhanjayatithibhagna| | (Shabdasthoma )
PARYAYA Bhagna, Bheda, Bhedana, Bhanjana, Vibhaga. NIDANA
Patana,Peedana,Praharena,Akshepana,Vyalamrugadashana, Balavadnigraha, Abhipatanishesha
EFFECT OF TRAUMA ON BONES :1. Cartilage's Bend2. Long bones -Break3. Flat bones - Crack4. Teeth - Fragmented5. Curved bones - Crack or Break.
SUSHRUTA'S TECHNIQUE IN THE MANAGEMENT OF AVRA NAKANDABHAGNA
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CLASSIFICATION OF BHAGNA
[A] 1) Sandhimukta 2) Kandabhagna. (Sushruta)
[B] 1) Sandhibhagna 2) Asandhibhagna.(Vagbhata)
[C] 1)Savrana bhagna 2) Avrana bhagna.(Madhukosha)
Classification of Kandabhagna
Name ofBhagna
Sushruta Vagbhata A.H.
Vagbhata A.S.
Charaka BhavaPrakasha
MadhavaNidana
Sharangadhara
Karkataka + + + --- + + ---Ashwakarana + + + --- + + ---Choornita + + + --- Vichoorni
taVichoorn
ita---
Picchita + + + --- + + ---Asthichallita + + + --- + Asthichall
ika---
Kandabhagna + Vellita Vellita --- + + ---Majjanugata + + + --- + Majjagata ---Atipatita + + + --- + + ---Vakra + + + --- + + ---Chinna + Shoshita Shoshita --- + + ---Patita + Darita Darita --- + + ---Sphutita + + + --- Visphutita + ---
SUSHRUTA'S TECHNIQUE IN THE MANAGEMENT OF AVRA NAKANDABHAGNA
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GENERAL FEATURES OF 'KANDABHAGNA'
Shvyathubahulyam
Sparshasahisnutvam
Avapidyamane shabda
Vividhavedanapradurbhavah
Sarvasu Avasthasu Na Sharmalabha
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 TECHNIQUE IN THE MANAGEMENT OF AVRA NAKANDABHAGNA
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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 OF AVRA NAKANDABHAGNA
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TYPE OF
PROGNOSIS
PATIENT
FRACTURE BONE
FRACTURE
S EASONAL VARIATION
AGESTATUS OF
SITE OF STATUS OF
SUSHRUTA'S TECHNIQUE IN THE MANAGEMENT OF AVRA NAKANDABHAGNA
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(1) Local (2) Systemic.
(1) Local complications Malunion Fragmented Fracture.
(2) Systemic complications Fever, Abdominal distension, Cessation of passages of excreta
Due to tightbandaging
Swelling,pain,AvascularizationGangrene
(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.
SUSHRUTA'S TECHNIQUE IN THE MANAGEMENT OF AVRA NAKANDABHAGNA
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Four Principles of Treatment
1) Anchana (Traction) 2) Peedana( Manipulation)
3) Sankshepan(Opposition 4)Bandhana(Immobilization)
and stabilization)
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.
29SUSHRUTA'S TECHNIQUE IN THE MANAGEMENT OF AVRA NAKANDABHAGNA
Rehabilitation
1) MritapindaDharan 2) LavanaDharana 3) PashanaDharna
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THE LIST OF DRUGS IN THE MANAGEMENT OFFRACTURES
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 foodLive on strictest continence,
Over exposure to sun Physical exercises.
Shali rice, meat soup,Milk, ghee, soup of pulse andNutritive and constructive food and drink,
CCCLLLIIINNNIIICCCAAALLL SSSIIIGGGNNNSSS OOOFFF IIIDDDEEEAAALLLLLLYYY UUUNNNIIITTTEEEDDD BBBOOONNNEEE
1) No swelling or hardness on palpation.
2) Absence of shortening and deformity.
3) Painless and easy movements
SUSHRUTA'S TECHNIQUE IN THE MANAGEMENT OF AVRA NAKANDABHAGNA
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MMMAAANNNJJJ IIISSSTTTHHHAAA
YYYAAASSSHHHTTTIII MMMAAADDDHHHUUU
SUSHRUTA'S TECHNIQUE IN THE MANAGEMENT OF AVRA NAKANDABHAGNA
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SSSHHHAAALLLIII
SSSHHHAAATTTAAADDDHHHOOOUUUTTTAAA---GGGRRRIIITTTHHHAAA
SUSHRUTA'S TECHNIQUE IN THE MANAGEMENT OF AVRA NAKANDABHAGNA
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RRRAAAKKKTTTAAA CCCHHHAAANNNDDDAAANNNAAA
DDDRRRUUUGGGSSS UUUSSSEEEDDD FFFOOORRR KKKSSSHHHEEEEEERRRAAAPPPAAAKKKAAA
GHRISHTA-KSHEERA
SUSHRUTA'S TECHNIQUE IN THE MANAGEMENT OF AVRA NAKANDABHAGNA
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LLLAAAKKKSSSHHHAAA
SUSHRUTA'S TECHNIQUE IN THE MANAGEMENT OF AVRA NAKANDABHAGNA
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DRUGS USED FOR THE SPLINTS
UDUMBAR
AAASSSHHHWWWAAATTTTTTHHHAAA
SUSHRUTA'S TECHNIQUE IN THE MANAGEMENT OF AVRA NAKANDABHAGNA
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PALASHA
VANSHA
, ,
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.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 Phalangeswhich can be reduced by closed reduction methodwith 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.
43SUSHRUTA'S TECHNIQUE IN THE MANAGEMENT OF AVRA NAKANDABHAGNA
Trial Procedure
Investigations X- RAYLaboratory investigations
MANAGEMENT OF FRACTURES IN GROUP -A.
44SUSHRUTA'S TECHNIQUE IN THE MANAGEMENT OF AVRA NAKANDABHAGNA
Drug Supply and Dosage: Lakshaksheera Paka was
given 100ml. Daily in the morning.
Ahara : Patient's usual vegetarian and non vegetarian dietwas continued with restrictions of Lavana, Katu, Amla rasa,Kshara and Ruksha dravyas.
Vihara: Atapa sevana and Vyayama were restricted.
RADIOGRAPHS SHOWING HEALING OF BONE
Follow up:Parameters of assessmenta) Subjective improvement. b) Objective improvement.
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