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 most frequently 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 in Jos, 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.