Complicações das intervenções dos bancos de ossos locais em pacientes ortopédicos internados no Hospital Imam Khomeini em Urmia durante o segundo semestre de 2015 e acompanhamento do resultado do tratamento pelo médico ortopedista

Local bonesetters are part of the health system in many developing countries. Their acceptability is beyond the boundaries of social classes and religious educations and beliefs. The objective of this research is to evaluate the causes of people admission to local bonesetters and the complications of local bonesetters' interventions in orthopedic patients and to follow-up the outcome of their treatment. In a prospective study with follow-up, patients' demographic information, complications of bonesetters' interventions, the reason for patients' admission to these individuals, the cost spent in this process and the delayed time for admission of these people to medical specialized services were collected. Data were analyzed by SPSS 21 software. In this research, a total of 61 patients were examined, which 28 (45.9%) of the patients stated that they would admit to bonesetter in the case of re-fracture. The main reason to admit to bonesetter among the patients was low cost of admission to bonesetter in 20 cases (32.8%), belief in better treatment by bonesetter in12 cases (19.7%), lack of trust in medical system in 7 cases (11.5%), recommendation of acquaintances and friends in 13 cases (21.3%), and short period of treatment by bonesetter in 9 cases (14.8%). This rate of admission to local bonesetter is directly correlated to the socioeconomic level of patients. Specialized orthopedic remedial measures following local bonesetters' interventions sometimes lead to failure and lack of recovery.Los sobanderos locales forman parte del sistema de salud en muchos países en desarrollo. Su aceptabilidad está más allá de los límites de las clases sociales y las enseñanzas y creencias religiosas. El objetivo de esta investigación es evaluar las causas de la admisión de personas a los sobanderos locales y las complicaciones de las intervenciones locales de las personas que arreglan fracturas en pacientes ortopédicos y hacer un seguimiento del resultado de su tratamiento. En un estudio prospectivo con seguimiento, la información demográfica de los pacientes, las complicaciones de las intervenciones de sobanderos, la razón por la cual los pacientes ingresaron a estas personas, el costo invertido en este proceso y el tiempo de demora para la admisión de estas personas a servicios médicos especializados fueron recogidos. Los datos fueron analizados por el software SPSS 21. En esta investigación, se examinaron un total de 61 pacientes, de los cuales 28 (45,9%) de los pacientes declararon que admitirían el sobandero en caso de fractura. La principal razón para admitir que los pacientes tenían mala conducta era el bajo costo del ingreso en 20 casos (32.8%), la creencia en un mejor tratamiento por parte de los sobanderos en 12 casos (19.7%), la falta de confianza en el sistema médico en 7 casos (11.5%)., recomendación de conocidos y amigos en 13 casos (21,3%), y corto período de tratamiento con sobanderos en 9 casos (14,8%). Esta tasa de ingreso al huesero local está directamente relacionada con el nivel socioeconómico de los pacientes. Las medidas de remediación ortopédicas especializadas después de las intervenciones locales a veces llevan al fracaso y a la falta de recuperación.Os desossadores locais fazem parte do sistema de saúde em muitos países em desenvolvimento. Sua aceitabilidade está além dos limites das classes sociais e dos ensinamentos e crenças religiosos. O objetivo desta pesquisa é avaliar as causas da internação de pessoas nos consertos locais e as complicações de intervenções locais de pessoas que fixam fraturas em pacientes ortopédicos e monitorar os resultados de seu tratamento. Em um estudo de acompanhamento prospectivo, informações demográficas dos pacientes, as complicações de intervenções hueseros, a razão pela qual os pacientes foram admitidos a essas pessoas investiram neste atraso de custos e tempo de processo para a admissão destes pessoas para serviços médicos especializados foram coletadas. Os dados foram analisados pelo software SPSS 21. Nessa investigação, foram examinados 61 pacientes, dos quais 28 (45,9%) dos pacientes declararam que admitiriam o preparador de ossos em caso de fratura. O principal motivo para admitir que os pacientes apresentavam mau comportamento foi o baixo custo de admissão em 20 casos (32,8%), a crença em melhor tratamento por parte dos consertadores de ossos em 12 casos (19,7%), a falta de confiança na sistema médico em 7 casos (11,5%). ), recomendação de conhecidos e amigos em 13 casos (21,3%), e curto período de tratamento com fixadores de ossos em 9 casos (14,8%). Essa taxa de internação para o organizador de ossos local está diretamente relacionada ao nível socioeconômico dos pacientes. Medidas especializadas de remediação ortopédica após intervenções locais às vezes levam ao fracasso e à falta de recuperação

Functional outcome after total hip replacement following 30 years neglected posterior hip dislocation: a rare case report

Neglected traumatic dislocations of the hip is one of disabling condition in lower extremity which are seldom found in adults. However, in developing countries, neglected-unreduced traumatic dislocations are not uncommon. Total hip replacement (THR) still remains a recommendation for the treatment of neglected hip dislocation which occurs more than 3 months. A 45- years-old female came to the outpatient clinic complaining pain on her right hip with history of trauma 30 years before, but instead of seeking medical treatment, she went to bonesetter instead. On physical examination, there is 5 cm leg length discrepancy, and the patient walked with limping gait. Conventional x-ray confirmed persistent dislocation of the right hip. A soft tissue release procedure and femoral neck osteotomy with skeletal traction was done before, followed by delayed THR two months after. The patient’s functional status was improved, and the HHS score increased from 48 to 87. The patient had no pain or significant complaints, except for a finding of mild residual Trendelenburg gait

TYPES OF INJURIES SEEN IN PEOPLE PERFORMING TEAM SPORTS AND ANALYSIS OF THESE INJURIES ACCORDING TO DIFFERENT VARIABLES (BURSA SAMPLE)

This research aims to determine cognizance of sport injuries in male sportsmen between 16 and 28 ages in volleyball, basketball, football and handball players. According to this research, injuries in male sportsmen between 16 and 28 ages in volleyball, basketball, football, handball branches in Bursa province and their cognizance of sport injuries, and the differences of these parameters according to branches are stated. The survey was conducted on 250 sportsmen. Participants’ average age was 19, 2±2, 79. In the present research, analyses of parameters were done by the computer program SPSS 16.0. While comparing of the continuous variables T Test and ANOVA were used. Categorical data were analyzed by using cross tables, chi-square test and Pearson’s Correlation Test. According to the results, muscle injuries, ligament, meniscus injuries and sprains were frequently seen. It was found that volleyball players take injuries more seriously than basketball player. More Injuries are at least taken into consideration by basketball players. It was also found that majority of the sportsmen that participated in the research; do not take specific precautions against injuries.  Article visualizations

Determinants of utilization of traditional bone setters in Ilorin, North Central Nigeria

Background. Traditional bone setting (TBS) practice is an important part of health care delivery in many developing coun- tries and has been in Nigeria for long. Despite the complications that arise from the cultural practice, TBS services is still in high demand by a significant number of people. This study was con- ducted to determine the factors that influence the utilization of TBS practice. Methods. A descriptive cross-sectional study was carried out using a semi structured questionnaire to gather information from 400 randomly selected residents of Ilorin West LGA in north cen- tral Nigeria. Multistage sampling technique was used in selecting the respondents. Results. The respondents were between the ages of 18-72 years with a mean age of 36.3 ± 12.3. Three hundred and three (77.3%) of the respondents know of TBS practice as a way of getting treat- ment for bone injuries. More than two third 210 (69.3%) of the respondents who know TBS practice as a form of treatment for bone injuries think that TBS therapy is preferable to Orthodox medicine in handling bone injuries. Reasons for preference are that it is cheap 134 (63.8%), acceptable 123 (58.6%) and accessible 109 (51.9%) to them. More than half (52.3%) of the respond- ents had patronized TBS treatment at one time or the other. Main reason for patronage of TBS was influence from family mem- bers and friends (53.6%). However, factors that influence the respondents decision to utilize TBS treatment include attitude of health workers 310 (77.5%), delay in hospitals 284(71.0%) fear of amputation 272 (54.35) and fear of operation 217(54.3%) in hospitals. There was a statistically significant (p inf. 0.05) relation- ship between respondents age, sex, marital status, occupation, ethnicity as well as the income level of the respondents and the utilization of TBS. Conclusions. Utilisation of TBS is quite popular among the stud- ied population because it is believed to be cheap, acceptable and accessible to them and a high proportion of the respondents uti- lize TBS notwithstanding that they live in a community where they have better access to orthodox medical care. Influence from fam- ily and friends is the main reason for consulting TBS. Regulations should be made concerning the advertisement of TBS practice by relevant agencies and the public should be made aware through health education on the dangers of TBS treatment

Why do people prefer traditional bonesetters in Sudan?

Background: In Sudan as in other developing nations, traditional bonesetters play a significant role in primary fracture care. There is widespread belief in our society that TBS are better at fracture treatment than orthodox practitioners. Significant numbers 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 Sudan. Objectives: A prospective study designed to determine the reasons of why a considerable number of people prefer to go to the traditional bonesetters in Sudan.Patients and methods: This prospective two stages study was carried out in two different stages, 1st stage in 2006 targeted general population, and the 2nd stage in the period from May 2009 to September 2009 targeted traditional bonesetters and their patients. In the 1st stage of the study we distributed a predesigned questionnaire to general population, while in the 2nd stage of the study we visited different traditional bonesetter in order to interview them and their visitors and completing the early prepared Performa. We excluded the too elderly patients and children who have nodecisions to choose TBS.Results: In the 1st stage of study the participants were 199 of them, 192 participants responded well to the questionnaire. The reasons why they went to traditional bonesetters were; in 71 participants (37%) was their beliefs, in 27 (14.06%) was due to the low cost, and in 27 (14.06%) was due to fear of plaster. In the 2nd stage of the study 276 participants fulfilled the criteria of the research. The reason why they went to traditional bonesetters; in 63 candidates (22.8%) was their beliefs (P value < 0.003), in 53 (19.2%) was low cost (P value < 0.05), and in 46 (16.7%) was due to fear of cast or amputation. Study included sixteen traditional bonesetters, of them 14 were males and 2 were females. One of them has a bachelor graduation from faculty of sciences. 11 (68.8%) traditional bonesetters accepted the idea of regular training under medical supervision.Conclusion: Despite an adequate number of physicians practising in the region, traditional bonesetters continue to be consulted. Study showed that a belief is the most leading cause of consulting traditional bonesetters, other causes including fear of plaster or amputation and less cost. We recommend that the efficacy of their treatments have to be further assessed.Keywords: Traditional bonesetter (TBS); Beliefs, medical services