FEMORAL FRACTURE NONUNION AND HOMOEOEPATHY: A CASE REPORT

Dr. Sunita Singh B.H.M.S Medical Officer (Homoeopathy) I/c DGHD Bank Enclave, Directorate of ISM & Homoeopathy, Email:drsunita2010@yahoo.com

Abstract A forty five years old patient suffering with non union of fractured femoral bone in spite of having undergone orthopedic surgery for internal fixation visited homoeopathic unit of LBS Hospital. He had suffered with post operative septicemia twice and was advised to undergo bone grafting,. Pain and depression made his life miserable. Two months of homeopathic treatment provided pain relief, removed depressive symptoms and improved callus formation. Key words Non-union fracture, homoeopathy, pyrogenium, symphytum, hypericum, calcarea phos Introduction A non- union of fracture means a permanent failure of healing following a broken bone .In general if a nonunion is still evident after six months of post injury it will remain unhealed without specific treatment usually orthopedics surgery .Nonunion of bones is categorized as (a) Hypertrophic non-union where callus forms but still non-union (b) Atrophic non-union no callus formation takes place. Bone grafting is usually advised for atrophic non-union. Most common causes of non-union of bone after fracture are (1) infections (2) inadequate blood supply to bone (3) separation of the fractured ends of the bone (4) inadequate stabilization of fracture . Homoeopathic treatment is useful in these surgical cases according to the directions of Hahnemann in aphorism 186 of Organon of medicine, Those so-called local maladies which have been produced a short time previously, solely by an external lesion, The treatment of such diseases is relegated to surgery; but this is right only in so far as the affected parts require mechanical aid, whereby the external obstacles to the cure, which can only be expected to take place by the agency of the vital force, may be removed by mechanical means, e.g., by the reduction of dislocations, by bringing into apposition the broken extremities of a fractured bone and retaining them in exact contact by an appropriate bandage, etc. But when in such injuries the whole living organism requires, as it always does, active dynamic aid to put it in a position to accomplish the work of healing, e.g. when the violent fever resulting from extensive contusions, lacerated muscles, tendons and blood-vessels requires to be removed by medicine given internally, or when the external pain of scalded or burnt parts needs to be homoeopathically subdued, then the services of the dynamic physician and his helpful homoeopathy come into requisition. Case report

A lean, thin forty five years old man visited homoeopathic unit of Lal Bahadur Shastri hospital on 20/1/11 for homeopathic treatment. He was suffering from non union of left femoral bone since one year and undergoing orthopedic treatment at the same set-up. Being the only earning member of the family it was getting tough to bear the day by day pain and weakness. He came to the dispensary taking support of his wife. He felt depressed due to ongoing agony. He had also suffered with septicemia twice after the orthopedic surgery and was advised bone grafting as callus formation was not taking place. He was taking calcium supplements and pain killer medicines, which he was asked to discontinue while on homoeopathic treatment.

Case analysis The symptomatology considered for prescribing was: 1) H/O post operative septicaemia (twice) 2) No or very slow callus formation 3) Pain or post traumatic neuralgia (after fracture) at the site of fracture 4) Pale weak anaemic patient suffering with agony and pain since last one year As these symptoms indicated some well known remedies of our materia medica, repertory was not consulted. Prescription & follow-up 20-1-11 Treatment was started with Pyrogenium 200 two dose stat followed by Hypericum 200/od and symphytum 6 /tds for a week. 27/1/11 A week later he reported with improvement in weakness and pain. Treatment was continued with Hypericum 200/od and Symphytum 6/tds for next two weeks. 8/2/11 After two weeks patient came to the dispensary using a walking stick without his wifes support . Patients demeanor reflected his cheerfulness and he reported a marked reduction in pain along with increased strength in leg. As the patient was pale and anaemic he was now prescribed Calacrea phos 6x /tds along with Symphytum 6/tds . The patient continued on these medicines for nearly two months. Repeat X-ray on 29/3/11 revealed improvement in callus formation.

Seeing the improvement in callus formation in the x-ray, doctors at orthopedic department of the hospital advised him to continue with homeopathic treatment. Discussion Postoperative septicaemia is an important reason for non-healing of fracture and Pyrogenium is a well known homoeopathic remedy indicative in such situations as it covers chronic complaints that date back to septic conditions, sapraemia or septicaemia, puerperal or surgical. Hypericum perforatum was prescribed for the post-traumatic neuralgia accentuated furtherpost-operative. Symphytum was prescribed because it is known to facilitate union of fractured bones. Calcarea phos is an important tissue remedy sometimes indicated in bone diseases, non-union of fractured bones, secondary anaemias and chronic wasting diseases. Literature further mentions it promotes callus formation. Conclusion Homoeopathic treatment may speed up callus formation as has been suggested by this case. Since complete follow-up could not be done, so it cant be conclusive. Further case studies and research may provide further evidence. Bibliography 1. Allen, HC. Keynotes And Characteristics with Comparisons of some of the Leading Remedies of the Materia Medica. B.Jain publishers (P) Ltd, India. Reprint edition 2006. 2. Boericke, W. New Manual of Homoeopathic Materia Medica & Repertory. B. Jain Publishers (P) Ltd,India. Augmented Edition 2000 3. Hahnemann, S. Organon of Medicine, 186. B.Jain publishers(P)Ltd, India. 2008 4. www.orthopedics.about.com as accessed on 15/10/13 5. www.en.wikipedia.org/wiki/non-union as accessed on 14/10/13