Traditional bone setting: an avoidable cause of major limb amputations

Background: Despite the availability of modern health care services, patients in Nigeria still seek treatment by traditional bone setters. One of the major complications of this type of native fracture treatment is limb gangrene necessitating amputations. The objective of this study was to determine the role of traditional bone setting in major limb amputations.Methods:  This retrospective study was carried out at a government orthopedic referral hospital. The study involved all patients who underwent major limb amputation between January 2015 and December 2019 in our center. Data were retrieved from medical records and operation registers. Information regarding age, sex, indications and levels of amputation and complications were studied.Results: During the study period; of the 297 major limb amputations performedd, 194 (65.3%) were due to traditional bone setting. The median age of the patients was 11.0 years (1 to 45 years) and the interquartile range was 10 years. Majority of the patients 86 (44.3%) affected were children less than 10 years of age. Male were more affected than female (M:F=1:2). Lower limb is more affected than the upper limb. The commonest amputation done was below knee amputation in 79 (40.7%) of cases. The commonest complication was surgical site infection which occurred in 32 (16.5%) patients.Conclusions: Traditional bone setting is a leading cause of major limb loss especially in children