Review of the Practice of Traditional Bone Setting in Nigeria

Background: The practice of traditional bone setting (TBS) is extensive in Nigeria and it enjoys enormous patronage by the populace. However; the outcome of the intervention of TBS treatment is usually poor with profound effects on the patient. There are many publications highlighting different aspects of this subject but none has summarized the entire practice and problems as a single publication. Objective: This work aims at reviewing the entire subject of traditional bone setting in Nigeria in a single article to enable easy understanding and appreciation of the practice and problems of traditional bone setting by orthodox practitioners. Method: A total of thirty-one relevant published original scientific research papers involving all aspects of the subject were reviewed and the practices and problems were documented. Results: The results showed that the origin of the practice is shrouded in mystery but passed on by practitioners from one generation to another. There is no formal training of bonesetters. Though the methods of treatment vary; the problems caused by them are usually similar with extremity gangrene being the worst. When attempts have been made to train the bone setters; improvement have been noted in their performance. Conclusion: In other to prevent some of the most debilitating outcomes like amputation; it is suggested that the TBS practitioners undergo some training from orthopaedic practitioners

Lower Limb Injuries Arising From Motorcycle Crashes

Background: Motorcycle accidents are the second most common cause of road traffic accidents in both developing and developed countries. In this study we aim to look at the pattern and characteristics of lower limb injuries arising from motorcycle accidents and evaluate early outcome of treatment. Methods: All the patients with lower limb injuries arising from motorcycle accidents who presented in our hospital between 1st October 2006 and 30th September 2007 were reviewed. History was obtained and detailed examination was done after resuscitation to determine the site; nature and the characteristics of injuries. Definitive treatment (conservative or operative) given was based on the pattern and type of injuries. Patients were followed up in the clinic for both clinical and radiological review. Functional outcome assessment was commenced after the onset of weight bearing. The data were recorded on a designated proforma and analyzed using a statistical programme. Results: A total of 429 motorcycle accident victims were seen during this period and lower limb injuries represented the commonest type of injury(238; 55.5). Male: female ratio was 2.2:1 with a mean age of 43.1years. Fractures were the commonest lower limb injuries(73.4) and closed fractures were commoner than the open fractures. The commonest anatomical location of fractures in lower limbs was tibial shaft. Joint stiffness was found to be the commonest post treatment complication. Conclusion: Lower limb injuries represent the commonest form of injuries among the motorcycle accident victims. Fractures were the commonest type of injury seen and the most common location was shaft of tibia

Management of Civilian Gunshot Injuries to the Extremities in Nigeria-an Overview

There is an increasing incidence of missile injury attributable to improved technology; and increased crime and conflict rates in both developing and developed nations of the world. We undertook a review of civilian gunshot injuries to the extremities in Nigeria. The pathology of these injuries as well as their implications for management are presented. The peculiar challenges they present to the orthopaedic surgeons in the management of gunshot injuries in a resource depleted country are highlighted. Community based socially and culturally acceptable conflict resolution mechanisms; control of fire arms and revision of the treatment guidelines are recommended as preventive and management strategies of gunshot injuries in Nigeria