Traditional bone setters′ gangrene: An avoidable catastrophe, 8 years retrospective review in a private orthopedic and trauma center in South-East Nigeria

Chika, Agu Thaddeus; Onyekwelu, Jide

doi:10.4103/1118-4647.177496

Cited by 9 publications

(13 citation statements)

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“…Limb loss can result in significant morbidity, disability, and profound economic, social and psychological effects to the patient and family, especially in developing countries where prosthetic services are inadequate [ 10 ]. Chika et al reported that 15% of amputations in Nigeria were due to bone setter's gangrene, while nearly a quarter of all trauma-related gangrene were bone setter's gangrene [ 6 ].…”

Section: Discussionmentioning

confidence: 99%

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A catastrophic presentation of dead limb secondary to traditional bone setter's treatment in Sorong, West Papua: A case report

Luhur¹,

Dharmawan

Wiguna

2021

International Journal of Surgery Case Reports

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Introduction Traditional bone setter's gangrene is a devastating complication arising from the practice of TBS with a prevalence of 4.29%, and most cases require amputation, which led to permanent disability. This case demonstrates a catastrophic presentation of the lower limb gangrene secondary to traditional bone setter's treatment. Case presentation A 39-year-old man with history of treatment by traditional bone setter presented with generalized pain with loss of the skin throughout the entire right lower leg, leaving soft and hard tissue exposed to the environment. His vital signs showed tachycardia and fever. Pulses were absent on the entire lower leg except for the femoral artery. The radiograph revealed gas density around the soft tissue suggestive of gas gangrene. After stabilization, an above-knee amputation was performed by the orthopedic surgeon. Discussion Traditional bone setter's gangrene is a significant contributor to amputations in many developing countries. The practice of scarification, massage with herbal concoctions and creams, and a tight splint may lead to infection, vascular compromise, compartment syndrome that may terminate in gangrene or death of the limb. This progressive limb-threatening infection emphasizing the importance of early recognition of compartment syndrome, adequate resuscitation or stabilization, and prompt and aggressive treatment. Conclusion This case highlights the menace of TBS activities and the dangers inherent in their practice. People who are misguided by false beliefs should be educated by public enlightenment. Appropriate legislation should be supplemented by the government to integrate traditional bone settings with the new orthopedic care services.

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Section: Discussionmentioning

confidence: 99%

“…The only treatment for gangrene is amputation, and this is devastating to the patient and family members, even when it is the only life-saving option. The loss of the limb results in a lifetime disability and stigma, impacting the patient and the family [ [5] , [6] , [7] ].…”

Section: Introductionmentioning

confidence: 99%

A catastrophic presentation of dead limb secondary to traditional bone setter's treatment in Sorong, West Papua: A case report

Luhur¹,

Dharmawan

Wiguna

2021

International Journal of Surgery Case Reports

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“…14 Available evidence shows that they employ the use of concoctions, unsanitary and tight splint on fractures, which often result in compartment syndrome, and then, gangrene. [15][16][17] It, therefore, comes as no surprise that approximately, 60% of major limb amputations and as much as 80% of fracture morbidity in hospitals in Nigeria are attributed to their actions. 5 Moreover, the process of training and skills acquisition in traditional bone setting is flawed.…”

Section: Introductionmentioning

confidence: 99%

“…19 Their services are well-kept family secrets and ancestral heritage, handed down the generations through oral tradition. 5,11,15,20 The activities are, also, undocumented, shrouded in mystery, culture, fetish practices and incantations. 16,17 They are not regulated, and thus, quality may be questionable.…”

Section: Introductionmentioning

confidence: 99%

Are Medical Students willing to Patronize Traditional Bone Setters in the Future? A Study among Medical Students of Ebonyi State University Abakaliki, Nigeria

Ossai¹,

Agu²,

Eze³

et al. 2021

J. Com. Med. and PHC

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Background: A large proportion of fractures are still managed by traditional bone setters in developing nations. The study was designed to determine the willingness to patronize traditional bone setters in the future among medical students of Ebonyi State University Abakaliki, Nigeria.Methods: This was a descriptive cross-sectional study of all preclinical and clinical medical students of the university. Information was obtained using a pretested, self- administered questionnaire. Data were analyzed using IBM SPSS statistical software version 22.0 and level of statistical significance was determined by a p value of < 0.05.Results: A total of 385 students participated in the study (response rate; 83.7%). Mean age of respondents was 23.2±3.4 years. One quarter of the respondents, 82 (25.0%) have patronized traditional bone setters before. About half indicated that traditional bone setters receive more patronage than orthopedic surgeons, however three-quarters of them preferred services of Surgeons. Two-thirds opined that bone setters have more treatment failures, and only 72 (18.7%) were willing to patronize traditional bone setters in future. Major reasons to patronize them included skilled/good service delivery, 34 (47.2%) and low cost, 21 (29.2%). Predictor of willingness to patronize traditional bone setters in future was previous use of traditional bone setters, (AOR=8.3, 95%CI: 4.7-14.9, p<0.001)Conclusion: The practice of traditional bone setting is widespread and enjoys much acceptance in the society despite high rates of treatment failures associated with it. Thus, there is the need to monitor the activities of traditional bone setters to enhance competence and encourage referral.

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“…1 Given the high use of TBH services, there are now recommendations that TBH should be integrated into the healthcare system. 2 To date, published studies on TBH have largely focused on the prevalence of TBH; its use, its complications; the reasons for using TBH; and ways of integrating TBH with the contemporary orthopaedic system. 3,4 Studies that applied ethical principles to the pseudo-scientific aspect of this practice are largely missing.…”

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confidence: 99%

Ubuntu ethics and moral problems in traditional bone-healing

Ewuoso

Fayemi

Aramesh

2021

Journal of Global Health Reports

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Traditional bone setters′ gangrene: An avoidable catastrophe, 8 years retrospective review in a private orthopedic and trauma center in South-East Nigeria

Cited by 9 publications

References 0 publications

A catastrophic presentation of dead limb secondary to traditional bone setter's treatment in Sorong, West Papua: A case report

A catastrophic presentation of dead limb secondary to traditional bone setter's treatment in Sorong, West Papua: A case report

Are Medical Students willing to Patronize Traditional Bone Setters in the Future? A Study among Medical Students of Ebonyi State University Abakaliki, Nigeria

Ubuntu ethics and moral problems in traditional bone-healing

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