Extremity Amputations in Children from Complications of Traditional Bone Setters' Care Seen in a Tertiary Hospital in Port Harcourt, Nigeria

Abstract

Background: The ancient practice of traditional bone setting dates back many centuries. In the developing world, the traditional bone setters are still patronized despite numerous limb and life-threatening complications that result from their treatment of limb injuries. Limb amputation in children resulting from bonesetter's gangrene is a common and a disturbing complication.   Aim: To present six consecutive cases of extremity amputations in children resulting from bonesetters' gangrene. Results:  Six consecutive extremity amputations resulting from bonesetters' gangrene were done at the study site from April 2013 to March 2016, constituting 8% of all limb amputations and 73% of all extremity amputations done in children within the same period. Five of the patients were males while one was female. Ages ranged from 18months to 17 years with a mean age of 10.2±13.3 years.  All amputations involved the upper limb. All patients visited the traditional Bone setters (TBS) with five of patients ‘admitted' in the Bone Setter's place for more than two weeks. The treatment method was similar in all patients and involved the use a tight splint localized to the fracture site and intermittent massage using a local ointment. All patients had satisfactory wound healing and were discharged home not later than the 14th-day post surgery.   Conclusion: Limb gangrene is one of the most regrettable complications following Traditional Bonesetters treatment of extremity injuries. With the poor rehabilitative function of amputated limbs and the high cost of the functional prosthesis in the sub-region, urgent steps are needed to prevent such complications in the sub-region.