Richard C. Echem^1,, Phillip D. Eyimina¹

Background: Traditional bone setting is an ancient healing art and is rife in sub-Saharan Africa. Traditional bone setter’s gangrene of the upper extremity in children is a serious complication of fracture care by traditional bone setters. Aim: To document upper extremity gangrene in children resulting from the practice of traditional bone setting as seen in a tertiary health institution. Methods: A prospective study of children presenting with upper extremity gangrene from the care of traditional bone setters at the University of Port Harcourt Teaching Hospital from January 2006 to December 2018. Data obtained included the patients socio-demographics and relevant information related to the injury. Data was analysed with SPSS version 20. Results: Fifty-two children with upper extremity gangrene were seen. Their ages ranged from 1.5 to 14 years and most were males. Their parents mostly had primary and secondary levels of education and majority were married. The most common injury was humeral supracondylar fractures. These injuries were majorly from falls. Duration before presentation ranged from 2 to 5 weeks. Majority had massage, splinting and bandaging from the bone setter. Most common associated complication at presentation was sepsis. They all had provisional amputation. Most common amputation level was above elbow. The amputation stumps were refashioned from 5 to 35 days. Four had split skin grafting. Duration of hospital stay ranged from 9 to 108 days. There was no mortality. Conclusion: Upper extremity gangrene in children is a preventable sequelae of traditional bone setting. Parental health education is necessary to discourage their patronizing traditional bone setters.

traditional bone setters, children, upper extremity, gangrene, fracture, management