Practice Of Traditional Bone Setting Research Articles

Knowledge, Attitude and Practice of Public School Teachers Regarding Traditional Bone Setters, Khartoum Locality

Background: In Sudan, traditional bone setting (TBS) is still popular and has serious complications. Therefore, awareness and education are essential for TBS. School teachers having a close association with students and parents could be an appropriate medium for health education about TBS after evaluating their awareness. Objectives: To review the knowledge, attitude, and practice among public school teachers toward TBS practice. Methodology: A community-based cross-sectional descriptive study 588 school teachers participated from Khartoum locality, Sudan. Data were collected using self-administered questionnaires. Results: Of 588 participants, 246 (41.8%) were males and 342 (58.2%) were females having the age range between 22 and 65 years, and (69.2%) received bachelor’s degrees. Around 249 (42.4%) believed that all/some of the TBSs had good basic knowledge and 331 (56.3%) participants thought that all/ some of the TBSs had clinical knowledge and skills. Half of the participants 300(51%) believed that some/all TBSs knew about trauma complications and 283(48.1%) participants believed that all/some of TBSs can make an accurate diagnosis. The two main reasons for the popularity of TBS were the cost (60%) and illiteracy (52.9%). Most of the teachers (79.8%) will take their injured students directly to the hospital. (41%) teachers visited TBS for themselves, and around 51% showed their commitment to TBS. Most teachers (96%) said that they will advise parents to take their child to the hospital, while only 4% said they will advise taking them to the TBS. In a situation, if the parents insist on taking their child to TBS, the majority (67.7%) teachers will advise the parents to take their students to the hospital. Conclusion: The study demonstrates that most participants’ knowledge level was below expectations and they have a positive attitude and strong beliefs toward the traditional bone setters. Making awareness in society is essential by organizing educational programs introducing how orthopedic hospitals are better for fracture treatment than traditional bone setters. Keywords: Traditional bone setters, knowledge, attitude, practice, fracture, school.

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

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.

TRADITIONAL BONE SETTING PRACTICE OF RABHA PEOPLE OF ASSAM

Objective: The aim of this work is to document the various ethnomedicinal healing plant species used in traditional bone setting (TBS) practice of Rabha community of Assam.Methods: This has been done using interview method which includes semi-structured questionnaire and the field walks method.Results: The results reveal that eight healing plants wear employed to in the TBS practice. Among these, Cissus quadrangularis L. is the most commonly used plant species to treat bone fracture. In this study, two modes of preparation for the ethnomedicine have been served (i.e., paste and extract) where paste form has higher used (75%).Conclusions: It has been concluded that Rabha Hasong area of Assam is indeed rich in ethnomedicinal plants. People get benefited from the traditional practices performed by the medicine men. This is the chief reason TBS practice that is still running smoothly with full faith and hope even in the current time where sophisticated orthopedic treatments are obtainable. Moreover, systematic nutraceutical appraisal of these species would provide a remarkable research possibility in the fields of ethnopharmacology that would be useful in the modern orthopedic treatments.

TRADITIONAL BONE SETTING PRACTICE OF RABHA PEOPLE OF ASSAM

Objective: The aim of this work is to document the various ethnomedicinal healing plant species used in traditional bone setting (TBS) practice of Rabha community of Assam.Methods: This has been done using interview method which includes semi-structured questionnaire and the field walks method.Results: The results reveal that eight healing plants wear employed to in the TBS practice. Among these, Cissus quadrangularis L. is the most commonly used plant species to treat bone fracture. In this study, two modes of preparation for the ethnomedicine have been served (i.e., paste and extract) where paste form has higher used (75%).Conclusions: It has been concluded that Rabha Hasong area of Assam is indeed rich in ethnomedicinal plants. People get benefited from the traditional practices performed by the medicine men. This is the chief reason TBS practice that is still running smoothly with full faith and hope even in the current time where sophisticated orthopedic treatments are obtainable. Moreover, systematic nutraceutical appraisal of these species would provide a remarkable research possibility in the fields of ethnopharmacology that would be useful in the modern orthopedic treatments.

Complications of traditional bone setters (TBS) treatment of musculoskeletal injuries: experience in a private setting in Warri, South-South Nigeria.

IntroductionComplications arising from the practice of traditional bone setting is a major contributor to the challenges the orthodox orthopaedic practitioner in Nigeria faces. We share our experience at a multi-specialist private health facility in Warri, South-south, Nigeria.MethodsCase notes of patients with musculoskeletal injuries who had prior treatment by traditional bone setters with resulting complications before presenting at our health facility for treatment were reviewed and relevant information extracted and entered in an already prepared proforma. Data were analysed using SPSS version 17 and results presented in form of means, percentages, ratios and tables.Results43 cases were reviewed in a period of 8 years. There were 21 males and 22 females. The average age of patients was 44.8 ± 20.3 years. The most frequent age group affected was that of 40-49 years. 45.8% of the initial injuries were due to road traffic accidents while 39.5% resulted from falls. Femoral fractures and humeral fractures formed 20.4% and 14.8% of cases respectively. 40.8% of traditional bone setters complications observed were non-union of fractures of various bones followed by mal-union in 24.5% of cases.ConclusionThe observed complications of traditional bone setters practice in this study were similar to those previously reported in the literature. These complications constitute a significant challenge to the orthopaedic practitioner in Africa with associated negative socioeconomic impact on our society. Government and other relevant stakeholders need to unite and take decisive actions to mitigate this problem.

Traditional Bone Setting: Analysis of Contribution and Patronage in Northern Ghana

Traditional bone setting (TBS) has made significant contributions in the area of primary health care and remains one of the oldest medical practices that numerous people in Africa patronise. This study examines TBS practice including patients’ experiences and factors that influence people and patients’ adoption decision. Using structured questionnaire and interviews, the study revealed how efficacy, quick services, nature of the bone injury as well as recommendations from families and friends who had ever visited a traditional bone setting practitioner significantly influenced the level of probability of adoption. However, though the cost of treatment and fast rate recovery had significant influence on adoption, they were not compelling enough in increasing the probability of adoption as compared to earlier-mentioned factors. The study concludes that in areas where allopathic medicine has failed, traditional bone setters have succeeded, there is therefore the need for proper recognition, investments and integration of this essential practice into modern health system especially in regions where health care infrastructure and staffing are inadequate. Keywords : Traditional, Medicine, Bone Setting, Treatment, Adaptation

Traditional Bone-Setters and Fracture Care in Ekiti State, Nigeria

In Nigeria, the practice of traditional bone setting (TBS) is extensive as in other developing nations. Traditional bonesetters play an imperative role in fracture care. Though, the outcome of the intervention of TBS treatment is usually poor with profound effects on the patient in the future. This study seeks to examine the activities of traditional bone setters on fracture care in Ekiti State, Nigeria. Survey method was applied in the study. 250 questionnaires were administered to owners of traditional bone centres and their clients respectively. Ten (10) of such centres were selected for the study in Ekiti. The findings indicated that majority of the bone setters had little or no formal education. Many of them acquired the schema used through ancestral/supernatural power. The TBS lack basic knowledge of investigations and wound care while most of their clients patronized them because of poverty, ignorance and superstitious beliefs. Provision of adequate basic equipment in health institutions may reduce the rate at which people utilize Traditional bone centres against medical advice.

Management of the complications of traditional bone setting for upper extremity fractures: The experiences of a French Forward Surgical Team in Chad

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.

Determinants of utilization of traditional bone setters in Ilorin, north central Nigeria.

Traditional bone setting (TBS) practice is an important part of health care delivery in many developing countries and has been in Nigeria for long. Despite the complications that arise from the cultural practice, TBS services is still in high demand by a significant number of people. This study was conducted to determine the factors that influence the utilization of TBS practice. A descriptive cross-sectional study was carried out using a semi structured questionnaire to gather information from 400 randomly selected residents of ilorin West LGA in north central Nigeria. Multistage sampling technique was used in selecting the respondents. The respondents were between the ages of 18-72 years with a mean age of 36.3 +/- 12.3. Three hundred and three (77.3%) of the respondents know of TBS practice as a way of getting treatment for bone injuries. More than two third 210 (69.3%) of the respondents who know TBS practice as a form of treatment for bone injuries think that TBS therapy is preferable to Orthodox medicine in handling bone injuries. Reasons for preference are that it is cheap 134 (63.8%), acceptable 123 (58.6%) and accessible 109 (51.9%) to them. More than half(52.3%) of the respondents had patronized TBS treatment at one time or the other. Main reason for patronage of TBS was influence from family members and friends (53.6%). However, factors that influence the respondents decision to utilize TBS treatment include attitude of health workers 310 (77.5%), delay in hospitals 284(71.0%) fear of amputation 272 (54.35) and fear of operation 217(54.3%) in hospitals. There was a statistically significant (p < 0.05) relationship between respondents age, sex, marital status, occupation, ethnicity as well as the income level of the respondents and the utilization of TBS. Utilisation of TBS is quite popular among the studied population because it is believed to be cheap, acceptable and accessible to them and a high proportion of the respondents utilize TBS notwithstanding that they live in a community where they have better access to orthodox medical care. Influence from family and friends is the main reason for consulting TBS. Regulations should be made concerning the advertisement of TBS practice by relevant agencies and the public should be made aware through health education on the dangers of TBS treatment.

Complications and co-morbidities in radiographs of patients in traditional bone setters’ homes in Ogwa, Edo State, Nigeria: a community-based study

BackgroundMusculoskeletal injuries are common in developing countries, but access to high quality orthopedic care is not. Traditional bone setters (TBS) serve to fill the gap, but the nature and quality of their treatment are largely understudied. Traditional bone setting in Idunmunkpaghan clan of Ogwa community, Edo State, Nigeria, was founded by Odion Ekhimere between about 1680 and 1705. The TBS practice in this community is studied to find out the complications and co-morbidities associated with it. MethodsA prospective community-based study of the patients admitted in the traditional bone setters’ homes was done at Ogwa over a -2-year period by studying the admission and discharge radiographs of patients treated in the community and by interviewing the TBS and patients. ResultNinety patients with radiographs of the lesion sites were followed up from admission to discharge at the TBS homes, comprising 53 males (53.89%) and 37 females (41.11%) with a male to female ratio of 1.4:1. Sixty five patients (72.2%) had fracture or dislocation. Forty four of the 65 patients (67.7%) with fracture/dislocation had complications including mal-union 31(70.4%), secondary osteoarthritis 8 (18.2%), non-reduction of dislocation 7 (11.9%), non-union 8 (18.2%), and others 12 (27.2%). Co-morbidities were identified in 15 patients (16.7%) and included severe osteoarthritis 7 (46.7%), diabetic foot ulcer 4 (26.7%), severe hypertension with cardiomegaly 4 (26.7%), metastatic carcinoma of the prostate 3 (20.0%), septic arthritis 2 (13.3%), pulmonary tuberculosis 1 (6.7%) and others 3 (20.0%). ConclusionThe practice of traditional bone setting is well established in Idunmunkpaghan clan in Ukpogo quarter of Ogwa. Education and training of the TBS is the key to reduction of complications and co-morbidities seen in their practices as they have high patronage and the patients have high regards for them and will continue to patronize them.

Review of the practice of traditional bone setting in Nigeria.

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. 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. 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. 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. 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.

Puttur kattu (bandage) - A traditional bone setting practice in south India

Traditional bone setting practices are quite popular in India and nearly 6000 traditional bone setting Vaidyas (Practisioners) are practicing the same in our country. Puttur kattu is a traditional way of bone setting practice, invented accidentally by K. Kesava Raju in 1881. Now, the fourth generation of his family is practicing this bone setting practice in hospitals at Puttur, Andhra Pradesh, with 200-300 patients per day. A prospective study was undertaken to analyze the techniques in diagnosis, way of management, medicine preparation, plants used and way of applications by traditional bone setter (TBS) Vaidyas, with special reference to Puttur. We also tried to understand the reasons which make lots of people go to Puttur for getting treatment, means of contact for treatment, pathology of fracture and outcome of some treated cases through this study. 54% of the studied patients came to Puttur TBS on the advice of old patients. It is observed that more educated people are patronizing this therapy and 23% patients of the observed cases took discharge from modern hospital voluntarily to receive Puttur kattu treatment. 80% patients believed that this therapy with home remedy would fasten the healing process. 44% patients opted for this therapy due to fear of pain, heavy plaster of Paris bandage, prolonged period of immobilization, surgery and amputation. 71% patients of the followed cases were satisfied with the treatment of TBS of Puttur with minimum complications. The authors also attempted to put forth the legacy of the tradition, the way of management and the plant used for bone setting by the Puttur bone setting Vaidyas.

Outcome of traditional bone setting in the Middle belt of Nigeria

Background: This hospital based study was designed to elucidate the outcome of Traditional Bone Setting (TBS) practice in four states of the middle belt of Nigeria, via complications presenting in select hospitals.Methods: A combination of retrospective and prospective study of complications arising from traditional bone setting in Plateau and Nasarawa States and southern parts of the Kaduna and Bauchi States was undertaken.Results: Fifteen patients were retrospectively studied in the one year period between December 1999 and November 2000 inclusive, while seventy-six patients were recruited into a 1 year prospective study(January 2001 to December 2001). There were sixty-nine males and twenty-two females giving a male: female ratio of 3.1:1. The mostfrequently encountered patients were children in the first decade of life (34.1%), while the 3rd and 4th decades accounted for 20.9% and 18.7% respectively. 61.5% of the study population were residents inJos, Plateau State, and 19.8% were admitted from Nasarawa State. 12.1% came from Kaduna State while 6.6% were recruited from Bauchi State. The study population cut across all social strata with a preponderance of illiterates, children and primary school certificate holders. The presenting injuries clustered around femur, tibia and fibula, humerus and forearm with 19.61 each. These were followed by dislocations of hip, elbow and shoulders (15.2%). The presentation of complications included non union (13.1%), mal union (21.5%), volkman’s ischaemic contractures and compartment syndrome (8.4%), infections (24.4%), stiffness/ankylosis (15.9%) and gangrene (8.4%) among others. Eight two orthopaedic interventions were carried out ranging from minor procedures to open reduction and internal fixations (15.9%), amputations (7.3%) and arthroplasties (4.9%). Five portalities were recorded giving a mortality rate of (5.5%).Conclusion: 91 complications with 5 mortalities, largely avoidable in two years calls for a serious look at traditional bone setting practice in the Middle Belt of Nigeria. We recommend that other zones undertake similar studies so that a national picture would emerge and policy dialogue initiated.

The Practice Of Traditional Bone Setting In The South- South Region Of Nigeria

Objective: Modern day healthcare has greatly evolved following advances in technology and medical research. But despite the availability of these services, traditional bone setting has continued as a most sought after ‘alternative’ health service, especially in developing countries.This study therefore was carried out to investigate the practice of traditional bone setting in the Southsouth region of Nigeria. Design: Some popular traditional bone setters (TBS) were interviewed using a questionnaire designed to evaluate information such as the age, level of education, years of experience, mode of acquisition of skills, types of fractures treated, method of fracture treatment, types of complications and number of death recorded, class of people who come for treatment, mode of referrals to and from hospitals, assistance needed to improve their practice and ways to improve cooperation between TBS and orthodox practitioners. Result: The practice of TBS in Southern Nigeria seems have evolved and the TBS are inculcating modern methods into their practice.Conclusion: Revitalising the existing precious science of traditional bone setting would be a cost-effective alternative for the costly state of the art techniques of surgical reduction, heavy Plaster of Paris plasters and long periods of immobilisation.