Department of Orthopaedics and Traumatology, College of Medicine, Ambrose Alli University, Ekpoma, Edo State, Nigeria
Onuminya, J.E., Department of Orthopaedics and Traumatology, College of Medicine, Ambrose Alli University, Ekpoma, Edo State, Nigeria
Background. In developing nations traditional bonesetters (TBSs) play a significant role in primary fracture care. However, despite high patronage the TBS remains an untrained quack whose practice is often associated with high morbidity. This study evaluated the performance of a trained TBS in primary fracture care. Methods. Between 2002 and 2004 a prospective study was undertaken comparing the performance of a trained TBS with that of an untrained TBS at two separate locations. The two centres selected were both popular in traditional bone setting. A 1-day instructional course was given to the TBS at Afuje study centre, while the TBS at Ogua control centre received no instruction. The outcome of treatment of tibial shaft fractures at the two centres was evaluated and compared to assess the success of the course. Results. There was a considerable decrease in the rate of gangrenous limbs, infection, non-union and malunion at the trained TBS centre compared with the untrained TBS centre (2.5% v. 10%, 5% v. 12.5%, 7.5% v. 15%, and 20.0% v. 30%, respectively). The observed difference between the trained and untrained TBSs was statistically significant (p < 0.05). Conclusion. It appears that training TBSs can reduce morbidity rates fo llowing TBS treatment.
adult; aged; article; bone infection; clinical trial; competence; controlled clinical trial; controlled study; education program; female; fracture healing; gangrene; health practitioner; human; major clinical study; male; morbidity; Nigeria; paramedical education; primary health care; professional practice; tibia fracture; traditional medicine; treatment outcome; Adult; Aged; Female; Follow-Up Studies; Fracture Fixation; Health Care Surveys; Humans; Male; Medicine, African Traditional; Middle Aged; Nigeria; Prospective Studies; Rural Population; Tibial Fractures; Treatment Outcome