BHAGNA (FRACTURES) IN AYURVEDA: SUSHRUTA’S PRINCIPLES OF FRACTURE MANAGEMENT AND THE EVIDENCE FOR BONE-HEALING HERBS SUCH AS ASTHISHRINKHALA
Background: Fractures are a major global cause of disability, and delayed union and non-union remain clinical challenges. Sushruta described fractures and dislocations (Bhagna) in detail, including their classification, reduction, immobilisation and rehabilitation, together with herbs believed to promote bone healing. Asthishrinkhala (Cissus quadrangularis), literally “bone chain”, is the best-known of these. Objective: To review Sushruta’s principles of fracture management, compare them with modern orthopaedic principles, and summarise experimental and clinical evidence for Cissus quadrangularis in fracture healing. Methods: Narrative review of Sushruta Samhita and of experimental studies, clinical trials and recent reviews. Results: Sushruta classified Bhagna into dislocations (Sandhimukta, six types) and fractures (Kandabhagna, twelve types) and described reduction by traction, pressure and manipulation, immobilisation with splints, and graded rehabilitation, closely paralleling modern principles. Cissus quadrangularis extract promoted proliferation of bone marrow mesenchymal stem cells and osteoblast differentiation in vitro. Early clinical observations in India suggested faster healing. Small randomised trials in mandibular and maxillofacial fractures reported reduced pain and swelling, earlier radiological healing and higher serum calcium and alkaline phosphatase with Cissus quadrangularis, without reported adverse effects. A 2026 review judged these studies small, heterogeneous and short-term. Conclusion: Sushruta’s fracture principles remain valid and Cissus quadrangularis is a promising adjunct to standard fracture care. Larger, well-designed trials in long-bone and osteoporotic fractures are needed.
KEYWORDS: Bhagna; fracture; Kandabhagna; Sandhimukta; Asthishrinkhala; Cissus quadrangularis; bone healing; Sushruta