Table 1: Characteristics of articles included in review
|
S/NO
|
AUTHOR (YEAR)
|
COUNTRY
|
TARGET GROUP (SETTING)
|
TYPE OF STUDY/DESIGN
|
OUTCOMES
|
SUMMARY OF RELEVANT RESULTS
|
1
|
Dada et al. (2009)21
|
Nigeria
|
Patients with musculoskeletal injury treated strictly by a TBS
|
Prospective, non-interventional study; 121 patients with 155 musculoskeletal injuries
|
168 complications of treatment by TBS.
Cost of treatment by TBS compared to orthodox surgery.
|
1. Mal-union and non-union which each accounted for 27 (16.1%) cases.
2. The cost of treatment of the TBS ranged from USD 18-380, whereas, at the Orthopedic Hospital, it ranged from USD 34-98.
|
2
|
Callistus et al. (2013)
|
Ghana
|
Patients with musculo-skeletal injuries treated by TBS with complications over 5 years in Northern Ghana
|
Prospective non-interventional study of 230 patients
|
Complications of TBS Treatment.
|
1. Non-Union (20.9%)
2. Malunion (31.3%)
3. Infection (17%)
4. Ankylosis (7.8%)
5. Paralysis (5.2%)
6. Gangrene (2.6%)
7. Osteonecrosis (5.7%)
|
3
|
Panigrahi et al. (2017)
|
India
|
120 patients who presented to the outpatient department of a University Teaching Hospital over a 2-year period with fracture complications from TBS treatment
|
Prospective, non-randomized study of 120 patients with fracture complications
|
Pattern of complications of traditional bonesetters’ treatment.
|
1. Malunion (46%)
2. Non-union (20%)
3. Chronic osteomyelitis (6%)
4. Limb ischemia (28%)
|
4
|
Onuminya et al. (1999)4
|
Nigeria
|
Patients in Northern Nigeria who suffered complications of limb fractures and managed by TBS
|
Retrospective study; 25 patients aged between 5-50 years
|
Complications of treatment by TBS
|
- Gangrene (60%)
- Cellulitis (20%)
3. Compartment syndrome (20%)
|
5
|
Nwankwo et al. (2005)24
|
Nigeria
|
15 patients presenting with limb gangrene; aged 1-83 years, who had presented to a TBS for treatment of musculoskeletal injuries
|
Prospective, non-controlled cohort study; 15 patients
|
Outcomes in patients who had been to a TBS after they had reported to hospital
|
1. Gangrene (100%)
2. Toxemia (93.3%)
3. Amputation (100%)
4. Death (26.6%)
|
6
|
Zehir et al. (2015)30
|
Turkey
|
Bonesetter-intervened patients with complications of fractures treatment
|
Retrospective analysis of hospital records
|
Complications of treatment by a TBS in 55 patients who presented with complications.
|
1. Joint stiffness (14.8%)
2. Degenerative arthritis (6.2%)
3. Permanent nerve injury (3.1%)
4. Skin necrosis (3.1%)
5. Deformity (2.5%)
6. Compartment syndrome (1.8%)
7. Amputation (1.2%)
8. Nonunion (0.6%)
9. Limb shortening (0.6%)
|
7
|
Huang (1986)19
|
China
|
16 young adults, aged 16-43 years with neglected femoral neck fractures treated by a "Chinese bone setter"
|
Retrospective study of 16 cases of neglected femoral neck fractures
|
Outcomes of treatment of neglected femoral neck fractures initially seen by bone setters
|
- Leg shortening
- Upward displacement of the distal fragment
- Variable degree of absorption of the femoral neck or head
|
8
|
Doumi et al. (2007) 2009
|
Sudan
|
46 patients who underwent upper limb amputations at a teaching hospital over 5 year period
|
Retrospective study of 46 patients who had upper limb amputations.
|
11 out of the 21 children had gangrene from TBS splintage as the cause of upper limb amputation.
|
TBS Splintage for limb injuries was a major cause of gangrene in children (40.7%)
|
9
|
MIAEL Hag et al. (2010)
|
Sudan
|
36 Patients with fractures treated by TBS presenting with complications over 6 months at a Teaching Hospital in Khartoum Sudan.
|
Retrospective review of hospital records.
|
Complications of patients treated for fractures by bonesetters
|
1. Malunion (25.7%)
2. Nonunion (20%)
3. Compartment syndrome (14.3%)
4. Joint stiffness (11.4%)
5. Gangrene (8.6%)
|
10
|
Warman et al. (2018)
|
Indonesia
|
86 Patients with 109 limb fractures presenting with complications from TBS treatment within one year.
|
A hospital-based retrospective analysis of medical records.
|
Early and late complications of fracture treatment by TBS
|
1. Malunion (54.7%)
2. Joint stiffness (9.4%)
3. Non-Union (18.7%)
4. Neurologic impairment (7.8%)
|
11
|
Zulfiqar et al. (2018)
|
Pakistan
|
77 Patients who presented to the outpatient clinic after being managed by TBS over 6 months period.
|
Cross-sectional, prospective, non-randomized study.
|
Pattern of complications among trauma patients treated by TBS
|
1. Joint stiffness (22%)
2. Volkmann’s contracture (20.8%)
3. Skin necrosis (18.2%)
4. Non-union (3.9%)
|
12
|
Dastgir et al. (2012)
|
Pakistan
|
86 Patients with musculoskeletal injuries treated by TBS before presenting to a teaching hospital.
|
Prospective, non-randomized study.
|
Presence of complications after receiving TBS treatment.
|
1. Non-union (17.4%)
2. Malunion (24.4%)
3. Chronic osteomyelitis (17.4%)
4. Osteonecrosis (10.4%)
5. Gangrene (4.6%)
|
13
|
Prasad et al. (2015)
|
India
|
30 orthopaedic out-patients with TBS complications over 6 months period.
|
Prospective observational study.
|
Complications resulting from TBS fractures treatment
|
1. Malunion (36.7%)
2. Non-union (33.3%)
3. Myositis ossificans (16.7%)
4. Infections (6.7%)
|
14
|
Kumma et al. (2013)
|
Ethiopia
|
70 patients presenting to the emergency unit of a hospital with history of fracture treatment by TBS.
|
Prospective, cross-sectional survey.
|
Frequency of complications arising from the TBS fracture treatment
|
Joint stiffness (52.8%)
Infection (8.6%)
Non-union (5.7%)
Gangrene (4.3%)
Volkmann’s Contracture (5.7%)
|
15
|
Chowdhury
et al. (2011)
|
Bangladesh
|
120 Patients with fractures previously treated by TBS before presenting to 2 hospitals over a 1 year period.
|
Prospective multi-center study.
|
Methods of treatment by TBS that resulted in complications
|
Malunion (83.9%)
Non-union (14.7%)
Joint stiffness (11%)
Infections (22.1%)
Gangrene 1.5%
|