Practice and patronage of traditional bonesetting in Ondo State,Nigeria

Objective:This study was carried out to investigate the determinants of the practice and patronage of traditional bonesetting(TBS)in a Local Government Area of Ondo State,Nigeria.Materials and Methods:A descriptive research design approach with purposive sampling technique was used.Data collection was through the use of two set of self-developed structured questionnaire(for bonesetters and clients).The study obtained data from eight traditional bonesetters and fifty-six inpatients receiving treatments in the bonesetters’homes across the study location.Results:Findings from the study showed that the major cause of fractures were road traffic accidents while low cost of treatment was the major influence for patronizing traditional bonesetters.The study also revealed that majority of the traditional bonesetters had little or no formal education.Among the sociodemographic characteristics of the participants,only occupation showed signification relationship with reasons for patronage of TBS homes(χ^(2)=28.164,P=0.036).Conclusion:The patronage of traditional bonesetters may be impossible to eradicate;thus,the study recommends the need for collaboration among traditional bonesetters and modern orthopedic practitioners through recognition and continuous training of the traditional bonesetters on appropriate management and referrals.

Long Bone Non-Unions and Malunions: Risk Factors and Treatment Outcomes in Calabar, Southern Nigeria

Background: Diaphyseal non-unions and malunions constitute significant morbidities in fracture care. Fracture treatment modalities seek to restore anatomic orientation and functional rehabilitation as soon as possible after a fracture incident. Malunions and non unions present a treatment challenge with the need for prolonged hospitalization, multiple surgical interventions and economic burden. In the developing world, traditional bonesetting practices are popular and these often result in a host of preventable complications. The added socioeconomic costs of treating these complications present a considerable strain on the resources of these already fragile economies and households. Aim: To document the risk factors, treatment options and outcomes for diaphyseal non-unions and malunions in our environment. Patients and Methods: Fifty-two consecutive patients comprising 37 non-unions and 15 malunions who presented in the orthopaedic unit of a tertiary hospital in Southern Nigeria were evaluated. Information sought included biodata, location of pathology, type of incident fracture, local risk factors including traditional bonesetting;treatment options and final outcomes. Information obtained was analyzed using SPSS version 20 (IBM, New York). Results are presented in simple frequency tables. Results: There were 34 males and 18 females (M:F = 1.9:1) with a mean age of 38.76 ± 14.55 years. There were 37 non-unions and 15 malunions. The femur was the commonest site of pathology in 21 (40.4%) cases, and among the non-unions, the atrophic variety was the commonest type (n = 26;70.3%). The mean fracture-to-surgery interval was 11.35 ± 7.95 months and traditional bonesetting was the commonest risk factor (n = 36;69.2%). Plate and screw Osteosynthesis with bonegraft augmentation was the commonest treatment modality and the overall union rate was 94%. Conclusion: Traditional bonesetting plays a major role in the health seeking behaviour of many African societies. The complications are varied and add to the overall socioeconomic burden of fracture care in these developing economies. Identification of traditional bonesetting practices as an important risk factor should translate into a focus on these practices in preventive public health decisions in fracture care. Continuing public health education backed by political will and can potentially drive a paradigm shift in health seeking attitudes in the developing word.