Primary malignant bone tumours in Ibadan, Nigeria: an update.

Bone tumours are relatively rare compared to tumours of other sites. The frequency of primary malignant bone tumours is low in our environment, as was observed in an earlier study. The aim of this study is to update the information available on the pattern of primary malignant bone tumours at the University College Hospital (UCH), Ibadan, Nigeria. The medical records of 49 patients with malignant bone tumours documented in the Cancer Registry of UCH, Ibadan between January 2001 and September 2007 were reviewed retrospectively. The results were then added to those of the previous study published in 2002. This brought the number of cases of primary malignant bone tumours to 163 from January 1977 to September 2007. Primary malignant bone tumours represented 0.53% of the 30462 cases of cancer seen in the hospital in the period studied. The male female ratio was 1.5:1. About 44% of the tumours occurred among patients less than 20 years of age. Osteogenic sarcoma was the commonest malignant bone tumour. Important changes recorded in the seven years since the last review from this centre include; a rise in the prevalence rate of primary malignant bone tumours (49 new cases in the last seven years as compared to 114 cases over 23 years), the male-female ratio of Osteogenic sarcoma showed a decline (1.5:1 as compared to 1.6:1), and there was an increase in the prevalence of primary malignant bone tumours in the 0-9 years and > 60 years age groups. The significance of these findings will need to be determined by further studies.

The practice of traditional bonesetting: training algorithm.

Traditional bonesetters (TBS) have been in Nigeria for centuries. Up to 85% of patients with fractures present first to the traditional bonesetters before coming to the hospital and therefore this mode of care delivery cannot be overlooked in Nigeria. We attempted to document the current practice of TBS in Ibadan and their methods of fracture treatment with a view to training and improving the services offered by them. We carried out a literature search to review all previous studies on traditional bonesetters' practice and visited a few of them to document their current practice. The only change in the management of fractures by the TBS over the past 28 years was the use of spiritual methods of healing to treat open comminuted fractures; a technique for which no scientific basis was readily discernible. There is a need to educate and train the TBS in effective management of both open and closed fractures. Such training should be provided by orthodox orthopedic surgeons with a view to minimizing mismanagement of fractures. To this end, we propose a training algorithm.