Complications in fractures treated by traditional bonesetters in Khartoum, Sudan

Mohamed Imad A EL Hag, Osman Bakri M EL Hag


Background: Traditional bone setting (TBS) is widely practiced in the Sudan without adequate studies and published data concerning its complications.
Objectives: This study aimed to evaluate types and severity of complications seen in patients treated by TBS.
The study also aimed to assess factors that may predispose to potential complications.
Design: A retrospective and a hospital-based study.
Setting: The main Teaching Hospitals in Khartoum, Sudan.
Patients: Thirty-six patients with history of injury treated by TBS presenting with complications were evaluated
clinically and radiologically along with their topographic and socioeconomic variables.
Results: The majority of cases (66.7%) were children and young adults with a mean age of 28 years, ranged 6 – 80 years and with a male to female ratio of four. Attendants of TBS were mainly from low socioeconomic classes.
The commonest complication encountered was mal-union (25.7%) and non-union (20%). Other complications reported include compartment syndrome (14.3%), osteomyelitis (8.6%), restriction of movement (11.4%) and
Volkmann's contractures (5.7%). Gangrene was seen in three cases (8.6%), all ended in amputations. Malunion complicated peri-articular fractures that require internal fixation, while non-union was seen in fractures of shafts of long bones. Gangrene was associated with application of tight splints (tabb) and Volkmann's contracture occurred in children.
Conclusions: TBS can be associated with severe complications that may necessitate drastic treatment like amputation. Increasing the awareness of the possible complications could help in reducing complications.

*Corresponding author: Department of Anatomy, Case Western Reserve University, 11408 Belflower,Cleveland, Ohio 44106, USA. E. mail: Tel: 014407150125

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ISSN: 1858-5345