The prevention of traditional bone setter’s gangrene

Abstract

The Journal of Bone and Joint Surgery. British volumeVol. 87-B, No. 9 CorrespondenceFree AccessThe prevention of traditional bone setter’s gangreneA. AGARWAL, R. AGARWALA. AGARWALSearch for more papers by this author, R. AGARWALSearch for more papers by this authorPublished Online:1 Sep 2005https://doi.org/10.1302/0301-620X.16755AboutSectionsPDF/EPUB ToolsDownload CitationsTrack CitationsPermissionsAdd to Favourites ShareShare onFacebookTwitterLinked InRedditEmail Sir,We read with interest the article in the January 2005 issue by Eshete1 entitled ‘The prevention of traditional bone setter’s gangrene’. We appreciate the concern shown by Dr Eshete and his colleagues towards their community. Shah2 also reported encouraging results from an effort to bridge the gap between orthodox and unorthodox medical practitioners in Nepal. Although most reports of traditional healers originate from African countries, their impact is felt in all developing countries. In India, it is estimated that there are about 70 000 traditional healers and bone setters who treat 60% of all trauma patients.3 Little or nothing is known of how well these patients recover, although incidences of failure reported to health centres are damaging to the bone setters’ reputation.Bone setters will continue to exist. With their unscientific methods and without knowledge of anatomy, physiology or radiography, complications will inevitably occur. However, education plays a key role in influencing their method of treatment. They should be urged to adopt the fine example of Chinese healers, who refer complicated cases to orthopaedic experts in equipped centres. Interaction with traditional healers should not necessarily be one-sided. Some healers are experienced and have a sound knowledge of regional resources. For example, the Puttur bandage, which is a type of forearm bandage used in southern India, is considered superior to the normal ‘collar and cuff sling’ used by orthopaedic surgeons.4 This bandage supports the arm at the wrist and angle of thumb and palm, preventing wrist-drop.4Integrating the services of traditional bone setters into primary health care also requires a strong political commitment. They should be permitted and encouraged to attend as orthopaedic assistants in primary trauma departments of district hospitals.5 A particular village can be adopted by a teaching medical institution as part of a rural health scheme to provide education and to address the health problems of that particular region. This should be supplemented by legislation to regulate these traditional practices so as to limit them to what is considered safe. References 1 Eshete E. The prevention of traditional bone setter’s gangrene. J Bone Joint Surg [Br] 2005;87-B:102–3. Link, Google Scholar2 Shah RK. Comments. Trop Doct 1992;22:121. Google Scholar3 Church J. Regional news. World Orthopaedic Concern Newsletter Jan 1998;74. Google Scholar4 Shankar D. Traditional bone setting. http://planningcommission.nic.in/reports/sere-port/ser/seeds/seed_helth.pdf. (accessed 05/04/05). Google Scholar5 Onuminya JE, Obekpa PO, Ihezue CH, Ukegbu ND, Onabowale BO. Major amputations in Nigeria: a plea to educate traditional bone setters. Trop Doct 2000;30:133–5. Crossref, Medline, ISI, Google ScholarFiguresReferencesRelatedDetailsCited byComplications of paediatric elbow trauma treatment by traditional bonesetters1 April 2009 | Tropical Doctor, Vol. 39, No. 2Outcome of treatment of the mismanaged pediatric elbow trauma: A series of 73 cases7 July 2009 | Disability and Rehabilitation, Vol. 31, No. 5 Vol. 87-B, No. 9 Metrics History Published online 1 September 2005 Published in print 1 September 2005 InformationCopyright © 2005, The British Editorial Society of Bone and Joint Surgery: All rights reservedPDF download