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Abstract: Ibn Sina was a well-known
Islamic philosopher and physician. He
composed 276 works, the most famous of
which is “Al Qanun Fit Tibb.” This paper
highlights the bone fractures that may
occur, described in Ibn Sina’s book “Al
Qanun,” and reveals his accomplishments
and contributions to this field of medicine,
especially in what is now called the “Theory
of Delayed Splintage”.
Ibn Sina, or Avicenna
as known in the west, was born in the
year 980 A. D. in Afshana near Bukhara
in Turkistan, which is now called Uzbekistan.
He was considered as a prince of the physicians
during the Middle Ages. He composed many
books belonging to different fields. The
classification of his works according
to their content is as follow: 43 works
in medicine, 24 in philosophy, 26 in physics,
31 in theology, 23 in psychology, 15 in
mathematics, 22 in logic, 5 in the Holy
Koran interpretation. In addition, many
treatises in asceticism, love, music and
some stories(1).
Al Qanun Fit Tibb
represents the most important work
of Ibn Sina, and was known to the Europeans
through the Latin translations of Gerard
of Cremona, in the 15th century, and remained
in use in medical schools at Louvain and
Montpellier until the 17th century. According
to the Journal of UNESCO, October issue,
1980, Al Qanun book remained in use in
Brussels University until 1909.
Al Qanun book consists
of five books, the first concerned with
general medical principles. The second
with materia medica. The third with diseases
occurring in a particular part of the
body. The fourth on diseases not specific
to one bodily part (such as fevers), in
addition, to traumatic injuries such as
fractures and dislocations of bones and
joints. With the final book containing
a formula giving recipes for compound
remedies.
Ibn Sina devoted two
treatises in the fourth book of Al Qanun,
to fractures. The first treatise is entitled:
"Fractures as a Whole", and
the second is "Fractures of Every
Bone Separately".
In the first treatise,
he described the causes, types, forms,
methods of treatment, and complications
of fractures. While in the second treatise,
he determined the special characteristics
of fractures of each bone. Ibn Sina, in
this way, was very close to following
the format of modern medical textbooks.
The
first treatise:
Fractures
as a Whole
Ibn Sina defined a fracture
as a loss of continuation in the bone(2).
Then, he determined the types of fractures
such as transverse, longitudinal, or comminuted.
When he talked about symptoms and signs
of a fracture, he considered the pain,
swelling, and deformity of the limb to
be of great importance to the diagnosis.
In this chapter, Ibn
Sina distinguishes the fractures that
reach the joint line. He says: "If
the fracture was at the joint line and
healed, the movement of the joint could
be difficult as the rigidity of the callus
needs more time to become soft"(3).
It is well known now that fractures that
occupy the joint line, cause stiffness
of that joint after they heal, unless
convenient physiotherapy is applied to
the limb.
 Factors
that stimulate and inhibit bone healing
Ibn Sina mentions that
fractures of children heal more rapidly
than those of adults. He determined the
time span necessary for bone to heal.
He said, for example,
a nose bone fracture needs 10 days to
heal, a rib needs 20 days, a forearm needs
30 to 40 days, and a femur needs 50 to
120 days. It is clear that these figures
are similar to those written in modern
medical textbooks.
At the end of the chapter,
he pointed out the factors that affect
negatively bone healing, such as the lack
of a splint at the site of the fracture,
quickness in moving the affected limb,
loss of blood (anemia), and the existence
of a disease in the body(4). These factors,
and others, are now considered to have
a considerable role in delaying bone healing.
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