title: Complications and co-morbidities in radiographs of patients in traditional bone setters' homes in Ogwa, Edo State, Nigeria: a community-based study.
abstract: BACKGROUND
  Musculoskeletal injuries are common in developing countries, but access to high quality orthopedic care is not. Traditional bone setters (TBS) serve to fill the gap, but the nature and quality of their treatment are largely understudied. Traditional bone setting in Idunmunkpaghan clan of Ogwa community, Edo State, Nigeria, was founded by Odion Ekhimere between about 1680 and 1705. The TBS practice in this community is studied to find out the complications and co-morbidities associated with it.
  
  
  METHODS
  A prospective community-based study of the patients admitted in the traditional bone setters' homes was done at Ogwa over a -2-year period by studying the admission and discharge radiographs of patients treated in the community and by interviewing the TBS and patients.
  
  
  RESULTS
  Ninety patients with radiographs of the lesion sites were followed up from admission to discharge at the TBS homes, comprising 53 males (53.89%) and 37 females (41.11%) with a male to female ratio of 1.4:1. Sixty five patients (72.2%) had fracture or dislocation. Forty four of the 65 patients (67.7%) with fracture/dislocation had complications including mal-union 31(70.4%), secondary osteoarthritis 8 (18.2%), non-reduction of dislocation 7 (11.9%), non-union 8 (18.2%), and others 12 (27.2%). Co-morbidities were identified in 15 patients (16.7%) and included severe osteoarthritis 7 (46.7%), diabetic foot ulcer 4 (26.7%), severe hypertension with cardiomegaly 4 (26.7%), metastatic carcinoma of the prostate 3 (20.0%), septic arthritis 2 (13.3%), pulmonary tuberculosis 1 (6.7%) and others 3 (20.0%).
  
  
  CONCLUSIONS
  The practice of traditional bone setting is well established in Idunmunkpaghan clan in Ukpogo quarter of Ogwa. Education and training of the TBS is the key to reduction of complications and co-morbidities seen in their practices as they have high patronage and the patients have high regards for them and will continue to patronize them.
authors: Department of Radiology, Faculty of Medicine, College of Health Sciences, Nnamdi Azikiwe University, Nnewi Campus, Anambra State, Nigeria. ezechallenge@yahoo.co.uk
authors: Kenneth C
authors: KC
authors: Eze
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D003131:Combined Modality Therapy / Q000009:adverse effects / Q000379:methods; D005260:Female; D050723:Fractures, Bone / Q000150:complications / Q000000981:diagnostic imaging* / Q000628:therapy*; D006801:Humans; D004204:Joint Dislocations / Q000150:complications / Q000000981:diagnostic imaging* / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D026201:Musculoskeletal Manipulations / Q000009:adverse effects*; D009549:Nigeria; D011859:Radiography; D013165:Splints / Q000009:adverse effects*; D016896:Treatment Outcome; D055815:Young Adult