Role of Khanduchakka (Ehretia laevis) Lepan (local application) in the management of delayed union of metatarsal fracture: A case report

Abstract

Background: The application of Khanduchakka (Ehertia Laevis) Kalka (paste) in the case of Delayed-union of metatarsal fracture is an innovative idea. It is a case report having the fracture of 3rd and 4th metatarsal of right foot. Ehertia Laevis is folklore plant locally known as Khanduchakka used in fracture and wound healing in various forms by the tribal people. In the present case it is used as Lepan (local application). Observation after treatment shows that the Ehertia Laevis is an effective alternative treatment for fracture and delayed union of bones without any complications. Aim: To evaluate healing effect of Khanduchakka Lepan in the management of Delayed union of Metatarsal fracture. Material and Method: In this present case report, the patient with Delayed union of Metatarsal fracture was treated with Khanduchakka Kalka used as local application after all the mandatory investigations and its efficacy was evaluated on the basis of clinical parameters like pain, swelling and fracture healing. Statistical analysis used: 1. Universal Pain Assessment Tool i.e. Visual Analog Scale (VAS) scoring for pain. 2. Swelling was assessed by measuring affected foot circumference in centimeters. 3. American Orthopedic Foot and Ankle Scale (AOFAS) result was calculated. Results: Patient showed significance results in clinical parameters evaluated. He got partial relief within 2 weeks. Conclusion: X-Ray revealed that there was callus formation and the mal-union was slightly aligned just by simply applying Khanduchakka Kalka over a fracture. Visual analog scale used for pain showed before treatment score - 8/10 and after treatment score - 2/10. Circumference of swelling reduced from 33cm to 29cm. AOFAS score was improved from 38/100 to 79/100 points. Therefore it can be concluded that this intervention not only acts as fracture healing but also relieved symptoms of pain and swelling.