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Year : 2011  |  Volume : 14  |  Issue : 2  |  Page : 56-62

Clients, cost and consequences of unorthodox fracture and bone diseases care in Northern Nigeria

1 Department of Orthopaedic Surgery, Ahmadu Bello University Zaria, Nigeria
2 Department of Community Medicine, Bayero University, Kano, Nigeria
3 Department of Community Medicine, Ahmadu Bello University Zaria, Nigeria

Correspondence Address:
Y Z Lawal
Department of Orthopaedic Surgery, Ahmadu Bello University Teaching Hospital, Zaria
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Source of Support: None, Conflict of Interest: None

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Background: Despite poor outcome and increased complications, there is still widespread acceptance of traditional or unorthodox means of treating fractures and other diseases related to musculoskeletal system especially in the developing countries, regardless of social, economic or educational status. We studied characteristics of clients, cost and complications of such treatment among patients attending the trauma clinic at the Federal Medical Centre Katsina and the Ahmadu Bello University Teaching Hospitals, Zaria in northern Nigeria. Method: A prospective study of sixty patients, who presented to the trauma clinic of the two hospitals, was conducted from September 2005 to August 2010 using interviewer administered structured questionnaires. The socio-demographic characteristics of the clients, cost of treatment and pattern of complications were determined. Results: There is a widespread acceptance and patronage of traditional bone setting amongst the people of northern Nigeria. The M: F sex ratio was 4:1, with age range of 1 to 79 years and mean of 34. All patients were Muslims belonging to Hausa 40(66.7%) and Fulani 20(33.3%) ethnic groups. Majority 26(43.3%) had non-formal Qur'anic education while 8(13.3%), 10(16.7%) and 7(11.7%) had primary, secondary and tertiary education respectively. The average cost of treatment was $150. Reasons for patronage of traditional bonesetters principally include pressure from family members, perceived low cost and instant service. The commonest complications were limb-length discrepancy (28.3%), gangrene (15.0%), neglected posterior dislocation of femur (10.0%) and anterior dislocation of the shoulder (10.0%). Others include Volkmann's ischaemic contracture of the forearm (8.3%), fracture non-union (6.7%) andmalunion (5.0%) among others. Conclusion: Traditional bone setting is widely accepted in northern Nigeria despite high complication rates. It is therefore imperative for policymakers, health managers and Orthopaedic Surgeons to engage these practitioners in an unthreatening forum for the development of strategies to tackle this public health tragedy.

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