Onuminya John E
Department of Orthopaedics and Traumatology, College of Medicine, Ambrose Alli University, Ekpoma, Edo State, Nigeria.
S Afr Med J. 2006 Apr;96(4):320-2.
In developing nations traditional bonesetters (TBSs) play a significant role in primary fracture care. However, despite high patronage the TBS remains an untrained quack whose practice is often associated with high morbidity. This study evaluated the performance of a trained TBS in primary fracture care.
Between 2002 and 2004 a prospective study was undertaken comparing the performance of a trained TBS with that of an untrained TBS at two separate locations. The two centres selected were both popular in traditional bone setting. A 1-day instructional course was given to the TBS at Afuje study centre, while the TBS at Ogua control centre received no instruction. The outcome of treatment of tibial shaft fractures at the two centres was evaluated and compared to assess the success of the course.
There was a considerable decrease in the rate of gangrenous limbs, infection, non-union and malunion at the trained TBS centre compared with the untrained TBS centre (2.5% v. 10%, 5% v. 12.5%, 7.5% v. 15%, and 20.0% v. 30%, respectively). The observed difference between the trained and untrained TBSs was statistically significant (p < 0.05).
It appears that training TBSs can reduce morbidity rates following TBS treatment.
在发展中国家，传统接骨师在骨折的初级护理中发挥着重要作用。然而，尽管有很多人光顾，但传统接骨师仍然是未经培训的庸医，其治疗方法往往伴随着高发病率。本研究评估了一名经过培训的传统接骨师在骨折初级护理中的表现。
在2002年至2004年期间，进行了一项前瞻性研究，比较了一名经过培训的传统接骨师与一名未经培训的传统接骨师在两个不同地点的表现。所选的两个中心在传统接骨方面都很受欢迎。在阿富杰研究中心为传统接骨师提供了为期1天的培训课程，而奥瓜对照中心的传统接骨师没有接受培训。对两个中心胫骨干骨折的治疗结果进行了评估和比较，以评估该课程的成效。
与未经培训的传统接骨师中心相比，经过培训的传统接骨师中心坏疽肢体、感染、骨不连和畸形愈合的发生率有显著下降（分别为2.5%对10%、5%对12.5%、7.5%对15%和20.0%对30%）。经过培训和未经培训的传统接骨师之间观察到的差异具有统计学意义（p < 0.05）。
看来培训传统接骨师可以降低传统接骨师治疗后的发病率。
