Introduction   

Plants are the raw resources for various medicines since time immemorial. It’s quite amazing and a matter of fact, that some common medicinal plant species have some exceptional medicinal properties making them economically and ecologically valuable.  (Kumar, 2014).  Indigenous systems of medicines do not limit themselves just to fulfill the needs of primary health care, but have some specialized areas too. One among them is the fracture management, which is not a new fact; instead, it is somehow related to the conventional concept of Asthibhagna as is written in our Ayurvedic texts like, Atharva Veda, Shushruta samhita-nidana sthanaetc. (Murthy, 2004; Bhishagratna, 2006). Traditional drugs have often been the rich source for new drugs or active compounds for treatment of various ailments (Ghosh, 2003). Though ethnomedicinal plants cannot replace structural realignments, casts or surgical stabilization, but there are certain medicinal plants which contain necessary bioactive compounds (like phytoestrogens, minerals and cell proliferating agents) that help to accelerate bone cell differentiation, matrix mineralization and tissue recovery (Al-Ajalein et al., 2024). Today, one can easily detect and examine the fractured bone, directly under the radiological examinations (Abd Jalil et al., 2012). But there are some expert traditional herbal healers, who claim to do it, simply by their experienced hands without any ultra-modern techniques; they use the process, whatever they have learnt from their ancestors since more than hundred years. They take the help of some medicinal plant species to support them in their treatment. These healers claim that these approaches facilitate fractured bones healing however these require scientific validation and comparison with contemporary orthopedics techniques (Jha et al., 2022). The present paper is an endeavor in documenting & exploring the hidden skills of these indigenous herbal healers preserving their unique method of treatment. Simultaneously, it also focuses on the different plant species as is used by these communities in this treatment, in turn exploring their medicinal potential & efficiency.

Materials and methods

For the present study, field surveys were conducted in the year July 2021- July 2026, in Aurangabad, Murshidabad District of West Bengal.Ethno-medicinal information were recorded through interviews, discussions, field observations with the indigenous medicinal practitioners &herbal healers, locally called Kabirajs, Vaidyas, and clinically cured patients of the study area using semi- structured questionnaires (Rao, 1996; Table 1).The information about the plant species, their local name, parts used, drug preparation, mode of use and duration were documented in the survey. The relevant data were documented and compared with the existing literature and published research articles, books etc.  Most of the plants recommended by them are available in the field; either grows wild or is cultivated. Some of the plant parts are sold in the weekly local market called Haats. The locally available plants are collected from the field in their natural habitats (Jain, 1991; Alexiades, 1996; Martin, 2004).  Photographs were taken to support proper identification of the plant species (Figure 1). The plants were identified and herbarium specimens were prepared by comparing them with local floras (Haines, 1921–1925; Prain, 1903).

Theory Regarding Bone Fracture

Fracture is defined as a complete or incomplete separation in the continuity of the bone (Piermattei et al., 2006) Fracture healing is a complex physiological process that involves the coordinated participation of hematopoietic and immune cells within the bone marrow. In conjunction with vascular and skeletal cell precursors, it also includes mesenchymal stem cells (MSCs), which are recruited from the circulation and the surrounding tissues (Gullberg et al.,1997; Li et al., 2005). The two basic types of fracture healing process are the primary or direct fracture healing and the secondary or indirect fracture healing. Primary (direct) fracture healing occurs with very minimal callus formation. It is a direct attempt of bone to re-establish its continuity and thus requires direct contact of cells in the cortex (Singh, 2017).

Primary healing occurs rarely as the majority of fracture repairs undergo secondary or indirect healing (Giannoudis, 2007) Based on the histological observations, secondary fracture healing occurs in four overlapping phases, which are haematoma formation, early inflammatory (two to four weeks), repair (proliferation and differentiation, within a month or two), and late re-modelling phase (lasting for months or years) (Harwood  et al., 2005; Jahagirdar,2009).

Traditional Bandaging & Splinting Process

The principle of these traditional treatments is based mainly on the following structured physical immobilization processes (Figure 2):

1. Manual reduction (Setting): The healer gently pulls and realigns the displaced bone ends into their natural anatomical position.
2. Topical Herbal layering: Freshly prepared herbal paste is spread over the fractured site directly after applying the medicated oil prepared by them.
3. Herbal wrap: Papers are wrapped around the paste to retain moisture and keep the herbal actives in contact with the skin.
4. Splinting: Strips of Bamboo or rigid wooden sticks are placed around the wrap and tied with cotton cloth-strips to keep the joint immobilized. It restricts the dislocation of the already set bone. And this is retained for 5-8 weeks, depending upon the seriousness of the damage on bone, but dressing has to be changed in- between, at regular intervals of 5-7 days.
5. Massaging: It is another important part of their treatment. The affected part is massaged with their medicated oil, prepared from many medicinal plants, after the removal of the bandage. It must be applied, each time, during dressing. Massage period varies, depending upon the degree of severity of the affected part.
6. Restrictions: Only restriction is to avoid eating the sour things in diet. 

The medicated paste and oil prepared by them has the potential of coordinating the active participation of hematopoietic and immune cells within the bone marrow. Its heat generating & healing properties restores the usual circulations which were ceased due to the fracture.

Results and discussion

Results revealed that all the enumerated plant parts (Tables 2-3) are boiled in the Mustard (Brassica campestris-Family-Brassicaceae) oil, till it becomes thick and sticky and dark red colored (Till it reaches proper consistency). The prepared oil is then applied over the affected part as directed by these herbal healers. In this Ethno-botanical investigation, a total of 15 plant species belonging to 15 different families, were documented used by these herbal healers, for healing bone fractures. Traditional system of medicine of such herbal healers of the district lays a significant role in community healthcare. The local rural residents cannot afford the costly medical facilities. These traditional indigenous herbal healers have still maintained the hope for the locals. The locals have strong belief in their treatment. Now a day, not only the poor ones but also the urban people of the area, believe in their treatment. Simultaneously, it may help in healthy blending of these techniques with the modern systems of treatment, to pave the way for brighter, cheaper & a more effective system of treatment, for the future, healthier society.

Table 1: Indigenous herbal healers, called Kabirajs, practicing for 4 generations

Table 2: List of different medicinal plant species, used by these indigenous communities for the preparation of medicated paste

Table 3. List of different medicinal plants species used in preparing the medicated oil