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Current Trends in Science and Technology

an Open Access Publication ISSN: 0976-9730 | 0976-9498

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Orthopedic trauma care by Traditional Bone Setters in developing nations: An observational hospital study from Kashmir.

Mehraj-din Tantray
Government Hospital for Bone and Joint Surgery, Government Medical College, Srinagar, J&K, India-190010
Qazi Manaan Masood
Government Hospital for Bone and Joint Surgery, Government Medical College, Srinagar, J&K, India-190010
Qazi Danish Mushtaq
Medical Research Unit, Government Medical College, Srinagar, J&K, India-190010. Department of Biochemistry, Sri Pratap College, School of Sciences, University of Kashmir, Srinagar (J and K)-190001
Asif Nazir Baba
Government Hospital for Bone and Joint Surgery, Government Medical College, Srinagar, J&K, India-190010
Hilal Kotwal
Government Hospital for Bone and Joint Surgery, Government Medical College, Srinagar, J&K, India-190010
Qazi Waris
Government Hospital for Bone and Joint Surgery, Government Medical College, Srinagar, J&K, India-190010
Tabish Tahir
Government Hospital for Bone and Joint Surgery, Government Medical College, Srinagar, J&K, India-190010Tabish Tahir
Taseem A. Mokhdomi
Department of Biotechnology, University of Kashmir, Srinagar, J&K, India-190006.
Online First: February 15, 2018
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Abstract

According to estimates a quarter of all trauma patients in developing countries like India are initially managed by Traditional Bone Setters (TBS). Although many such patients have an uncomplicated recovery, many others have less than optimum outcomes. The objective of this study was to assess the outcomes in patients managed by TBS. The problems associated with such treatment include stiffness, malunion, myositis ossificans and the worst being Volkmann’s ischemic contracture and extremity gangrene. This work was an observational study conducted in the Department of Orthopedics, Government Medical College, Srinagar between July 2014 and January 2016. All the patients who presented to our hospital after initially being managed by TBS were included in the study. A standardized set questionnaire was used for all patients. A total of 600 patients (M:F::384:216; mean age 27±20.5 years) were included in the study. 76.16% of the patients belonged to rural areas and 71.5% were uneducated. 253 of the patients had soft tissue injuries only while the rest had various fractures/dislocations. Accessibility was the most common reason (31%) for visiting the TBS. A total of 305 patients had 360 complications ranging from the relatively innocuous stiffness of joints to gangrene of the leg. Based on the results we recommend a supervised short certification course for the TBS. We also list the various reasons for patronage of TBS, which can form the basis for intervention in order to modify behavior.

Keyword : Traditional bone setters; trauma care; developing nations; Gangrene

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Feb 15, 2018
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Feb 15, 2018
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References

1. Chris M, Kwaja A. Setting the Bones of Traditional Bone Setting. Journal of West African Insight 2011. 2. Green SA. Orthopaedic Surgeons. Inheritors of tradition. Clin Orthop Relat Res. 1999;363:258-63. 3. Church J. Regional news. World Orthopaedic Concern Newsletter 1998 (74). 4. Agarwal A, Agarwal R. The Practice and Tradition of Bone-setting. Journal of Education for Health. 2012;23(1):1-5. 5. Onuminya JE, Onabowale BO, Obekpa PO, Ihezue CH. Traditional Bonesetter’s Gangrene. Int Orthop 1999;23:111-112. 6. Onuminya JE, Obekpa PO, Ihezue HC, et al. Major amputations in Nigeria: A plea to educate traditional bone setters. Tropical Doctor 2000;30:133- 135. 7. Ofiaeli RO. Complications of methods of fracture treatment used by traditional healers: A report of three cases necessitating amputation in Ihiala, Nigeria. Tropical Doctor 1991;21:182-183. 8. Digest of Statistics 2013-2014. Planning and Development Department, Government of J&K.http://www.ecostatjk.nic.in/Digestofstat.pdf. Accessed on 11/07/16. 9. Jain AK. Orthopedics – Can India lead? JIMSA 2011;24:7-20. 10. Shrivastava SR, Shrivastava PS. Evaluation of trained Accredited Social Health Activist (ASHA) workers regarding their knowledge, attitude and practices about child health. Rural and Remote Health 2012;12:2099. 11. Hemmila HM, Keinanen-Kiukaanniemi SM, Levoska S, Puska P. Long term effectiveness of bone setting, light exercise therapy and physiotherapy for prolonged back pain: A randomized controlled trial. Journal of Manipulative and Physiological Therapeutics 2002; 25:99-104. 12. Panda AK, Rout S. Puttur Kattu (bandage) – A traditional bone setting practice in South India. J Ayurveda Integr Med 2011; 2(4):174–178. 13. Shang, TY, Gu YW & Dong FH. Treatment of forearm bone fractures by an integrated method of traditional Chinese and Western medicine. Clin Orthop Rel Res 1987; 215:56-64. 14. West S, Andrews J, Bebbington A, Ennis O & Alderman P. Buckle fractures of the distal radius are safely treated in a soft bandage. J Ped Orthop 2005; 25:322-325. 15. Khan I, Saeed M, Inam M, Arif M. Traditional bone setters; preference and patronage. Professional Med J. 2015; 22(9):1181-1185. 16. Thanni LO. Factors influencing patronage of traditional bone setters. West Afr J Med 2000; 19(3):220-4. 17. Bassey RB, Aquaisua AN,Edagha IA, Peters AI,Bassey EI. The Practice of Traditional Bone Setting In the South- South Region of Nigeria. The Internet Journal of Alternative Medicine 2011; 8(2). 18. Park K. “Park’s Textbook of Preventive and Social Medicine.” Banarsidas Bhanot Publishers, Jabalpur; 1994. 19. Eshete M. The prevention of traditional bone setter's gangrene. J Bone Joint Surgery Br 2005; 87-B:102-103 20. Onuminya JE. Performance of a trained traditional bonesetter in primary fracture care. South African Medical Journal 2006; 96:315-322. 21. Shah RK, Thapa VK, Jones DHA, Owen R. Improving primary orthopaedic and trauma care in Nepal. Education for Health 2003; 16:348-356. 22. Deo MG. Doctor population ratio for India—the reality. Indian J Med Res 2013; 137:632–635.
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References

1. Chris M, Kwaja A. Setting the Bones of Traditional Bone Setting. Journal of West African Insight 2011.
2. Green SA. Orthopaedic Surgeons. Inheritors of tradition. Clin Orthop Relat Res. 1999;363:258-63.
3. Church J. Regional news. World Orthopaedic Concern Newsletter 1998 (74).
4. Agarwal A, Agarwal R. The Practice and Tradition of Bone-setting. Journal of Education for Health. 2012;23(1):1-5.
5. Onuminya JE, Onabowale BO, Obekpa PO, Ihezue CH. Traditional Bonesetter’s Gangrene. Int Orthop 1999;23:111-112.
6. Onuminya JE, Obekpa PO, Ihezue HC, et al. Major amputations in Nigeria: A plea to educate traditional bone setters. Tropical Doctor 2000;30:133- 135.
7. Ofiaeli RO. Complications of methods of fracture treatment used by traditional healers: A report of three cases necessitating amputation in Ihiala, Nigeria. Tropical Doctor 1991;21:182-183.
8. Digest of Statistics 2013-2014. Planning and Development Department, Government of J&K.http://www.ecostatjk.nic.in/Digestofstat.pdf. Accessed on 11/07/16.
9. Jain AK. Orthopedics – Can India lead? JIMSA 2011;24:7-20.
10. Shrivastava SR, Shrivastava PS. Evaluation of trained Accredited Social Health Activist (ASHA) workers regarding their knowledge, attitude and practices about child health. Rural and Remote Health 2012;12:2099.
11. Hemmila HM, Keinanen-Kiukaanniemi SM, Levoska S, Puska P. Long term effectiveness of bone setting, light exercise therapy and physiotherapy for prolonged back pain: A randomized controlled trial. Journal of Manipulative and Physiological Therapeutics 2002; 25:99-104.
12. Panda AK, Rout S. Puttur Kattu (bandage) – A traditional bone setting practice in South India. J Ayurveda Integr Med 2011; 2(4):174–178.
13. Shang, TY, Gu YW & Dong FH. Treatment of forearm bone fractures by an integrated method of traditional Chinese and Western medicine. Clin Orthop Rel Res 1987; 215:56-64.
14. West S, Andrews J, Bebbington A, Ennis O & Alderman P. Buckle fractures of the distal radius are safely treated in a soft bandage. J Ped Orthop 2005; 25:322-325.
15. Khan I, Saeed M, Inam M, Arif M. Traditional bone setters; preference and patronage. Professional Med J. 2015; 22(9):1181-1185.
16. Thanni LO. Factors influencing patronage of traditional bone setters. West Afr J Med 2000; 19(3):220-4.
17. Bassey RB, Aquaisua AN,Edagha IA, Peters AI,Bassey EI. The Practice of Traditional Bone Setting In the South- South Region of Nigeria. The Internet Journal of Alternative Medicine 2011; 8(2).
18. Park K. “Park’s Textbook of Preventive and Social Medicine.” Banarsidas Bhanot Publishers, Jabalpur; 1994.
19. Eshete M. The prevention of traditional bone setter's gangrene. J Bone Joint Surgery Br 2005; 87-B:102-103
20. Onuminya JE. Performance of a trained traditional bonesetter in primary fracture care. South African Medical Journal 2006; 96:315-322.
21. Shah RK, Thapa VK, Jones DHA, Owen R. Improving primary orthopaedic and trauma care in Nepal. Education for Health 2003; 16:348-356.
22. Deo MG. Doctor population ratio for India—the reality. Indian J Med Res 2013; 137:632–635.
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  • Mehraj-din Tantray
  • Qazi Manaan Masood
  • Qazi Danish Mushtaq
  • Asif Nazir Baba
  • Hilal Kotwal
  • Qazi Waris
  • Tabish Tahir
  • Taseem A. Mokhdomi

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