Management of skeletal injuries needs a holistic approach and is not restricted only to fixing or uniting the fractures. For the management of these injuries, unique principles have been stressed upon including:reduction, immobilization, and physiotherapy.

Skeletal injuries have been classified into closed injuries and open injuries. In open injuries, priority is given to the management of wound to minimize the chances of infection.

Principles of management of closed skeletal injuries

1. Reduction - The first principle of fracture management involves realignment or correction of fracture fragments or the dislocated or sub-luxed joint to their anatomical positions. Acharya Sushruta emphasised on the techniques of closed reduction by the application of various forces like traction, compression, reduction or compression, pulling upwards, pressing downwards, etc.
2. Immobilization -Once the injury has been corrected or reduced, it must be immobilized or stabilizeduntil it unites. To attain immobilization, two methods have been described -splintage or external immobilization and fracture bed.

Prior to immobilizing the injured part by splint,a paste of drugs like Rubiacordifolia Linn, Glycyrrhizaglabra Linn, Pterocarpussantalinus Linn, a type of rice and 100 times washed clarified butter, should be applied on the affected part. Splints prepared from the barks or chips of trees such as Madhucaindica J.F. Gmel., Ficusglomerata Roxb., Butea monosperma Linn, Terminalia arjuna Roxb., Bambusaarundinacea Willd., Vateriaindica Linn. etc., are then applied and held using appropriate bandages.

3. Physiotherapy – It is a key component of management that helps torestore the normal functions of the affected part at the earliest. It works by gaining the strength of bones and soft tissues.

Besides technical management, other modalities includingmedications - oral, parenteral and local, dietary instructions and other lifestyle modifications are also important in the management of skeletal injuries.