Traditional methods for the treatment of fractures world-wide include the physical manipulation (resetting) of bones and traditional remedies in various dosage forms. Although traditional bone-setting is no longer widely practiced in most developed countries, traditional remedies (plant or animal derived) are still used to treat fractures. Traditional health practitioners administer a variety of herbal medicines for bone strengthening, pain relieving, inflammation reduction and speedy recovery of fractures. The aim of this study was to determine the types of treatment administered for fractures according to Zulu medicine practices in Kwazulu-Natal, South Africa and Māori medicine practices in the North Island of New Zealand. Traditional health practitioners who routinely practice in urban, semi-urban and rural areas of three districts each in Kwazulu-Natal, South Africa and in the North Island of New Zealand were surveyed between October 2018 and September 2019. A mixed method study was conducted by a survey, and a moderator with a single focus group of three traditional health practitioners, resulting in qualitative research based on their practices in the management of fractures and fracture-related injuries. In both South Africa and New Zealand, traditional health practitioners included in this study practiced in a similar way, mainly as Zulu herbalists or Izinyanga in South Africa (22/26, 84.6%) and as Tohunga-Rongoā or traditional Māori practitioners who are experts in medicine and healing (12/12, 100%) in New Zealand. Although the respondents were mainly Zulu herbalists in KwaZulu-Natal, South Africa, four practiced as diviners (Izangoma). Most of the respondents were male practitioners(20/38, 52.6%) who practiced for 11-20 years (13/26, 50%) in South Africa and the same length of time in New Zealand (5/12, 41.7%). It was interesting to note that traditional health practitioners interviewed in this study in both New Zealand and SA, no longer practiced the manipulation of bones or bone-setting. Rather they used traditional herbal mixtures with presumed fracture-healing activity. Traditional health practitioners surveyed in this study identified 47 traditional medicines from South Africa and 27 traditional medicines from New Zealand with presumed fracture-healing activity. The formulae for preparing these traditional medicines were documented. Traditional medicine preparations of Umhlabelo (Talinum caffrum) and Umahlanganisa (Drimia delagoensis) in South Africa, and Harakeke (Phormium tenax) and Tutu (Coriaria arborea) in New Zealand were most prescribed by traditional health practitioners to treat fractures. The use of a support structure for fractures to limit mobility (and prevent further injury) and promote healing by Zulu traditional health practitioners should be encouraged. Further investigation is warranted on the phytochemical compositions of the two most commonly used herbal mixtures identified above, each in South Africa and New Zealand.

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