RESUMEN

INTRODUCTION: Traditional bone setting, a centuries-old practice, remains a common method for treating musculoskeletal injuries in many parts of the world, particularly in developing regions. In Indonesia, traditional bone-setters are widely sought after in managing various bone and joint conditions. Despite the widespread use of traditional bone settings, there is limited documentation of their treatment outcomes and potential complications. Complications such as a necrotic limb due to vascular interruption as shown in our case are common complications of fracture reduction by individuals who have not been formally trained. CASE REPORT: This case report presents a 4-year-old boy, who came in the emergency department with pain on the arm after falling from the stairs. After a thorough examination, it was concluded that this patient has a displaced right proximal humerus fracture. The patient and family are educated about the surgery to treat the patient, but they refuse to do so. Two days later, the patient was referred to our hospital with a complaint of a blackened upper arm after undergoing a traditional bone-setting procedure. The patient's condition was characterized by loss of motor and sensory function in the affected limb, which was confirmed through clinical examination and imaging studies. He underwent shoulder disarticulation by an orthopedic surgeon in our center. This was decided because the limb was non-functional, inconvenient, and is at risk of becoming a focus of infection. DISCUSSION: Dead limb caused by traditional bone setters is a major factor leading to amputations in numerous developing nations. Techniques such as scarification, massage with herbal preparations, and the application of tightly fitting splints can result in infections, vascular impairment, and compartment syndrome, ultimately culminating in gangrene or limb loss. This case highlights the progressive and potentially limb-threatening nature of such infections, underscoring the critical need for early identification of compartment syndrome, prompt resuscitation or stabilization efforts, and immediate, vigorous treatment. CONCLUSION: This case is reported to highlight the risks associated with traditional bone-setting practices and the inherent dangers they pose. Individuals misled by misconceptions should be educated through public awareness campaigns. Additionally, governmental legislation should be enacted to integrate traditional bone-setting practices with modern orthopedic care services.

RESUMEN

World Health Organization stated that traditional medicine is an important part of health care and countries need to consider integrating it into their primary health care system. Traditional bone setting has a long history in Ethiopia and it enjoys enormous acceptance in the community. However, these methods are raw, there is no standardized training and at the same time, complications are common. Therefore, this research aimed to assess the prevalence of traditional bone setting service utilization and associated factors among people with trauma in Mecha district. Methods A Community- based cross-sectional study design was employed from January 15 to February 15, 2021. A total of 836 participants were selected using a simple random sampling technique. Binary and multiple logistic regressions were employed to assess the association between the independent variables with traditional bone setting service utilization. Results The prevalence of traditional bone setting service utilization was 46.05%. Factors significantly associated with TBS utilization were: Age ≥ 60 years (AOR = 0.13, 95% CI: 0.03- 0.43), rural residence (AOR = 3.63, 95% CI: 1.76 -7.50), occupation (merchant (AOR = 0.21, 95% CI: 0.07 -0.61), and housewife (AOR = 4.12, 95% CI: 1.33 -12.70), type of trauma: dislocation (AOR = 6.40, 95% CI: 3.69-11.10), and strain (AOR = 2.09, 95% CI: 1.05- 4.14)), site of trauma: extremity (AOR = 0.20, 95% CI: 0.11, 0.37), trunk (AOR = 0.08, 95% CI: 0.03-0.22), and shoulder (AOR = 0.20, 95% CI: 0.11-0.37), cause of trauma: fall down and natural deformity (AOR = 9.87, 95% CI: 5.93-16.42) and household annual income greater than > 36,500 (AOR = 2.33, 95% CI: 1.29-4.22). Conclusion The prevalence of traditional bone setting practice is high in the study area, despite recent advancements in the practice of orthopedics and trauma in Ethiopia. Since TBS services are more accepted in society, the integration of TBS into the health care delivery system is recommended.

Asunto(s)

RESUMEN

OBJECTIVE: Despite the access and availability of modern health care, Traditional Bone Setting (TBS) has a big place as alternative health care. Hence, this study was aimed to assess the preference of Traditional Bone Setting and associated factors among patients with a fracture. RESULTS: A total of 224 patients known to have fractured at Black Lion Hospital, Addis Ababa was included in the study. This study revealed that 29.9% of the study participants had a preference for the Traditional Bone Setting. Hospital admission (AOR = 8.158, 95% CI 1.179, 56.439), Traditional Bone Setting center as first port of call after injury (AOR = 0.004, 95% CI 0.001, 0.090), knowledge (AOR = 9.448, 95% CI 1.481, 60.251) and perception (AOR = 0.026, 95% CI 0.003, 0.215) were statistically significant. The preference for the Traditional Bone Setting is high. Hospital admission, Traditional Bone Setting center as a first port of call after injury, knowledge, and perception were significantly associated with the preference of Traditional Bone Setting. In addition to deployment of trained in trauma professionals, working more on awareness creation and training are recommended.

Asunto(s)

RESUMEN

The practice of traditional bone setting (TBS) in sub-Saharan Africa often leads to severe complications after upper extremity fracture. The purpose of this study was to evaluate the management of these complications by a French Forward Surgical Team deployed in Chad. An observational, prospective study was conducted over a six-month period between 2010 and 2011. During this period 28 patients were included. There were 20 males and 8 females with a mean age of 30.6 years (range 5-65 years). Thirteen patients (47%) had mal-union of their fracture, nine had non-union (32%), three children (10.5%) presented gangrene and three patients (10.5%) suffered from other complications. Fifteen (54%) patients did not undergo a corrective procedure either because it was not indicated or because they declined. Only 13 (46%) patients were operated on. Twelve of these patients were reviewed with a mean follow-up of 2.4 months. All of them were satisfied with conventional treatment. The infection seemed to be under control in every septic patient. Bone union could not be evaluated in most patients because of the short follow-up. Management of TBS complications is always challenging, even in a deployed Western medical treatment facility. Surgical expectations should be low because of the severity of the sequelae and the uncertainty of patient follow-up. Prevention remains the best treatment.

Asunto(s)

RESUMEN

BACKGROUND: The practice of traditional bone setting (TBS) is extensive in Nigeria and it enjoys enormous patronage by the populace. However, the outcome of the intervention of TBS treatment is usually poor with profound effects on the patient. There are many publications highlighting different aspects of this subject but none has summarized the entire practice and problems as a single publication. OBJECTIVE: This work aims at reviewing the entire subject of traditional bone setting in Nigeria in a single article to enable easy understanding and appreciation of the practice and problems of traditional bone setting by orthodox practitioners. METHOD: A total of thirty-one relevant published original scientific research papers involving all aspects of the subject were reviewed and the practices and problems were documented. RESULTS: The results showed that the origin of the practice is shrouded in mystery but passed on by practitioners from one generation to another. There is no formal training of bonesetters. Though the methods of treatment vary, the problems caused by them are usually similar with extremity gangrene being the worst. When attempts have been made to train the bone setters, improvement have been noted in their performance. CONCLUSION: In other to prevent some of the most debilitating outcomes like amputation, it is suggested that the TBS practitioners undergo some training from orthopaedic practitioners.

Asunto(s)