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Traditional bone setting: a risk factor in limb amputation.

E S Garba¹, P J Deshi

¹Department of Trauma and Orthopaedics, Ahmadu Bello University Teaching Hospital, Zaria, Nigeria.

East African Medical Journal

|September 24, 1999

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Most limb amputations in Nigeria result from trauma and gangrene caused by traditional bone setters. Training these practitioners in recognizing limb ischemia could prevent many of these surgeries.

Area of Science:

Orthopedics
Trauma Surgery
Public Health

Background:

Limb amputations are a significant surgical procedure with lifelong consequences for patients.
Traditional bone setters play a role in fracture management in many communities, particularly in low-resource settings.
Complications from improperly managed fractures can lead to severe morbidity, including the need for amputation.

Purpose of the Study:

To analyze the trends and causes of limb amputations over a decade at Ahmadu Bello University Teaching Hospital, Zaria, Nigeria.
To identify the primary pathologies leading to amputation and demographic characteristics of the affected patients.
To explore the role of traditional bone setters in fracture management and its impact on amputation rates.

Main Methods:

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A retrospective analysis of 225 limb amputations performed over a ten-year period.

Data collection included patient demographics, etiology of amputation, and level of amputation.

Statistical analysis to determine the prevalence of different causes and patient characteristics.

Main Results:

A total of 225 limb amputations were performed, with trauma and gangrene from inappropriate splintage by traditional bone setters being the leading cause (63.2%).
The male to female ratio was 4.6:1, with ages ranging from 2 to 85 years.
Above-elbow amputation (26.6%) and above-knee amputation were the most common levels.

Conclusions:

A significant proportion of limb amputations in this Nigerian tertiary hospital are preventable.
Inappropriate fracture management by traditional bone setters is a major contributor to limb loss.
Educational interventions and improved collaboration with traditional bone setters are crucial to reduce amputation rates.