Dr. Utibe Abasi Ime EDEM
Traditional bone-setters (TBS) are Traditional Medicine Practitioners who attempt to provide healing to bone and joint injuries and diseases, employing myth, superstition, experience and observations handed down from generation to generation. Their methods are often unscientific and not evidence-based as accidents and injuries are thought to have a spiritual association hence the need for concoctions and incantations. Interestingly, about eighty-five (85) percent of bone fractures present first to the bone-setters.
Their practice involves massaging, pulling, use of non-sterile appliances and non-use of imaging techniques in fracture management which can lead to various complications–pain, tetanus, osteomyelitis, joint stiffness, mal-union and non-union of broken bones leading to shortened limbs, compartment syndrome and resultant extremity gangrene, limb loss, some forms of cancers due to poor wound healing and sadly, and preventable deaths.
Despite the high complication rate associated with their practice, the patronage of TBS even by the elites of the society is quite high in our country because they are thought to be cheaper than orthodox medicine, payments can be made in cash, kind or in installments and they are easily accessible. There is also the belief by several persons that bone injuries cannot be managed by the medical doctor and that patients with such presenting in the hospital will have their limbs amputated or the use of plaster of paris (POP) will lead to gangrene of the limb. The management of these complications create a huge burden on the healthcare system especially on orthopaedic surgeons who are found mostly in tertiary centres. These treatment modalities could be non-operative or operative; including the use of casts, fixators, implants. These treatments can also be expensive.
Steps to reduce the menace should be the duty of all health personnel. This would include increased health promotion, advocacy, regulation of TBS practice, a sound referral system to cope with the uneven distribution of orthopaedic surgeons, encouraging students of healthcare professions to be interested in Orthopaedics in the course of their undergraduate training and enabling Universal Health Coverage.
#Education #Orthopaedics #2018