Indian Plastering Technique in Malleolar Fractures

Abstract

Ankle is the most common site where a lower limb fracture can occur. Ankle joint fracture can occur during sports activities and misstep on daily routine. Ankle joint fracture caused by an indirect trauma is about 9% of all other fractures. As far as the modern conservative management is concerned, a below knee plaster for a period of 3-6 weeks is sufficient enough to protect the fractured ankle joint without displacement. This type of plastering technique may cause some complications like muscle atrophy, cartilage degeneration, and a stiff, painful and swollen joint. Hence, an Ayurvedic approach is relevant in the management of ankle joint fractures. In Ayurveda, ankle joint fracture is termed as Gulphasandhi Bhagna. According to Susruta, initially a fractured ankle joint has to be reduced and then Bandhana should be done along with splint to prevent the movements of fractured fragments which is known as Kuśa Bandhana. There is another modified form of bandaging which is in practice over Southern parts of India and is conventionally known as Indian plaster. It is found to be very effective in the management of ankle joint fractures. It may be understood that it offers an optimal immobilisation. Even though splint bandage is the widely practised method, it has certain disadvantages. It may cause delay in healing. It requires the patient to tend more frequent hospital visits. Hence it is proposed to find out the efficacy of Indian plaster in malleolar fractures. A total number of 20 participants with malleolar fracture were selected and evaluated, by taking detailed history and clinical examination. The study was conducted at Shalyatantra OPD of V.P.S.V. Ayurveda college, Kottakkal. Indian plastering was done on 0th,14th and 28th days and retained up to 42nd day. The duration of the treatment was 42 days and follow up was done for 4 weeks after the intervention. Assessment was done on 0th, 14th, 28th and 42nd day for pain, tenderness, stiffness. Radiological assessment was done on 0th, 28th and 42nd day. The results were analysed statistically. On statistical analysis, it was found that the Indian plaster shows 77.74 % of the efficacy.