Fracture Management by Traditional Bonesetters: A Tertiary Care Hospital Based Observational Study

Abstract

Background: Fracture of bone is a persistent problem encountered in orthopaedic practice. The management of fracture of bone depends on reduction and immobility at the fracture site. The traditional bone setters formulate their own methods and practices for the management of fracture. This age-old art has not only survived since ages but also flourished with time and moreover to our surprise is challenging modern orthopaedic science in many ways. Aim of study: To find out various outcomes of fracture management by traditional bonesetters and the possible reason for their high patronage. Methods: Present study was conducted on patients with some kind of prior treatment received from TBS. The detailed history was collected about age, sex, socioeconomic condition, education, habit and habitats from each patient. Each case was subjected to detailed clinical and radiological examinations to evaluate the outcomes of the interventions of TBSs. Results: One hundred and fifty patients in the age group of (1–70) years were included in the study out of which 103 (69%) are male and 47 (31%) are females. 33% belong to age group of 30-45 years and 54% are of literate and fair socio-economic status. Malunion is the predominant form of presentation with 69 cases (46%) followed by non-union in 30 (20%) cases. 41 cases (28%) presented with impending ischemia at initial stages of treatment. Only 9 cases (6%) were presented with chronic osteomyelitis and infected non-union. Eventually 7 cases were ended with gangrene and amputation. Cost of surgery was the major cause (43%) followed by fear of surgery (23%) was observed for non-acceptance of modern orthopaedic system. Conclusion: The results in our study vindicate the fact that TBS play a major role in providing health care to the fracture patients. Lack of basic knowledge and aversion to referral system by TBS is responsible for complications. So, creating public awareness and integrating TBS in the healthcare system through proper training and due legislation seems to be the apt solution to combat this menace. Keywords: Traditional Bone Setters, chronic osteomylitis, Malunion and nonunion