Öz
Amaç: Kemik ve tendon yaralanmalarında gecikme telafisi mümkün olmayan komplikasyonlara yol açabilir. Ülkemiz de dahil pek çok ülkede, kırıkçı ve çıkıkçılar halen tedavide gecikme nedenidir. Bu çalışmamızda kırıkçı ve çıkıkçı müdahalesi nedeniyle gecikmiş hastaların tıbbi sonuçları ve olayda etkili faktörler incelendi.Çalışma planı: Ortopedi ve travmatoloji polikliniğimize Ocak 2010 ile Aralık 2012 arasında başvuran hastalardan kırıkçı ve çıkıkçılar tarafından müdahale edilenler çalışmaya dahil edildi. Hasta demografileri, klinik sonuçlanmaları ve olası sosyal etmenler analiz edildi. Komplikasyonların ve fonksiyon kayıplarının değerlendirmesinde klinik muayene ve radyolojik görüntüleme yöntemleri kullanıldı.Bulgular: Toplam 162 hastanın 97’si (%59.8) erkekti. Ortalama yaş 27.5±9.4 ve 89’u (%54.9) kırsal alanda yaşarken %69.2’sinde üst ekstremite yaralanması mevcuttu. Cerrahi tedavi 108 (%66.7) hastaya uygulandı. Hastalar, aile büyüğü olan akrabaların önerisiyle (%47.6) veya komşularının önerisiyle (%33.3) kırıkçıya gitmişti. İlkokul mezunları ve yeşil kartlılar daha sık kırıkçıya başvurmaktaydı (sırasıyla, p= 0.03 ve p<0.01). Hastaların kırıkçı ve çıkıkçıyı tercih nedenleri sıklıkla tedavi süresinin uzun olması ve sakat kalma korkusuydu (p=0.04). Hastaneye başvuranlarda komplikasyon oranı %33.9’du.Çıkarımlar: Yanlış tedavi olmalarına rağmen, hastaların eğitim eksikliği nedeniyle alternatif tedavi ilgisi gören kırıkçı ve çıkıkçı müdahaleleri, ülkemiz için halen sorun teşkil etmektedir. Çeşitli yayın organları ve sivil toplum örgütleri tarafından yapılacak uyarılar ve ortalama eğitim düzeyinin artması, çeşitli komplikasyonlara neden olabilecek bu yanlış yaklaşımın düzeltilmesinde etkili olacaktır
Anahtar Kelimeler
Kaynakça
- Ventevogel P. Whiteman’sthings: traininganddetraining- healers in Ghana. HetSpinhuis, Amsterdam 1996.
- World HealthOrganization (WHO). Thepromotion- and Development of TraditionalMedicine. TRS No.622, WHO, Geneva 1978.
- Doğan A, Sungur I, Bilgiç S, Uslu M, Atik B, Tan O, et al. Amputations in eastern Turkey (Van): a multicenter epidemiological study. [Article in Turkish] Acta Orthop Traumatol Turc 2008;42:53–8.
- Naddumba EK. Musculoskeletal trauma services in Ugan- da. Clin Orthop Relat Res 2008;466:2317–22.
- Onuminya JE. Performance of a trained traditional bone- setter in primary fracture care. S Afr Med J 2006;96:320– 2.
- Vukasinović Z, Spasovski D, Zivković Z. Musculoskel- etal trauma services in Serbia. Clin Orthop Relat Res 2008;466:2337–42.
- Ariës MJ, Joosten H, Wegdam HH, van der Geest S. Fracture treatment by bonesetters in central Ghana: pa- tients explain their choices and experiences. Trop Med Int Health 2007;12:564–74.
- Butt MF, Dhar SA, Gani NU, Kawoosa AA. Complica- tions of paediatric elbow trauma treatment by traditional bonesetters. Trop Doct 2009;39:104–7.
- Agarwal A, Agarwal R. The practice and tradition of bonesetting. Educ Health (Abingdon) 2010;23:225.
- Ersoy N. Bursa tıbbi folklorunda kırık-çıkıkla ilgili tedavi yöntemlerinden örnekler ve modern tıp bakımından bazı sonuçlar. Yüksek Lisans Tezi. Uludağ Üniversitesi, Sağlık bilimleri enstitüsü, Deontoloji ve Tıp Tarihi Anabilim Dalı Bursa 1986.
- Bamidele JO, Adebimpe WO, Oladele EA. Knowledge, attitude and use of alternative medical therapy amongst urban residents of Osun State, southwestern Nigeria. Afr J Tradit Complement Altern Med 2009;6:281–8.
- Dada AA, Yinusa W, Giwa SO. Review of the practice of traditional bone setting in Nigeria. Afr Health Sci 2011;11:262–5.
- Wilson JN. Iatrogenic gangrene in the Third World. Trop Doct 1991;21:137–8.
- Ofiaeli RO. Complications of methods of fracture treat- ment used by traditional healers: a report of three cases necessitating amputation at Ihiala, Nigeria. Trop Doct 1991;21:182–3.
- Onuminya JE, Onabowale BO, Obekpa PO, Ihezue CH. Traditional bone setter’s gangrene. Int Orthop 1999;23:111–2.
- OlaOlorun DA, Oladiran IO, Adeniran A. Complications of fracture treatment by traditional bonesetters in south- west Nigeria. Fam Pract 2001;18:635–7.
- Nunes B, Esteves MJ. Therapeutic itineraries in rural and urban areas: a Portuguese study. Rural Remote Health 2006;6:394.
- Ogunlusi JD, Okem IC, Oginni LM. Why patients pa- tronize traditional bone setters. Internet J Orthop Surg 2007;4.
- Dada A, Giwa SO, Yinusa W, Ugbeye M, Gbadegesin S. Complications of treatment of musculoskeletal injuries by bone setters. West Afr J Med 2009;28:43–7.
- Thanni LO. Factors influencing patronage of traditional bone setters. West Afr J Med 2000;19:220–4.
- Solagberu BA. Long bone fractures treated by traditional bonesetters: a study of patients’ behaviour. Trop Doct 2005;35:106–8.
Öz
Objective: Delaying the treatment of bone and tendon injuries may cause unmanageable complications. Bonesetters continue to cause delays in treatment. The purpose of this study was to analyze the medical outcomes of delay due to bonesetter intervention and factors affecting patient treatment preference.
Methods: Among outpatients treated at our clinic between January 2010–December 2012, bonesetter-intervened patients were included, and patient demographics, clinical outcomes, and possible social factors were retrospectively analyzed. Clinical examinations and radiological screening measurements were used to evaluate outcomes.
Results: Of the 162 patients, 97 (59.8%) were male, and mean age was 27.5±9.4 years. Eighty-nine (54.9%) of the patients lived in a rural area, and 108 (66.7%) underwent surgery. Bonesetter preference was dictated primarily by elderly relatives (47.6%) or neighbors (33.3%). Patients with a primary school education and unemployed patients mostly preferred bonesetters (p=0.03 and p<0.01, respectively), the explanation for which was the long treatment period and concern of being disabled (p=0.04). Complication rate among patients who were evaluated at a hospital was 33.9%.
Conclusion: Despite being medically unreliable and often times harmful, bonesetting is still accepted as an alternative treatment modality among uneducated patient and thus remains an ongoing problem in Turkey. Improvements in average education level and increased dissemination of accurate information via various media and non-governmental organizations will be effective in the correction and prevention of the afore-mentioned complications regarding bonesetter interventions.
Anahtar Kelimeler
Kaynakça
- Ventevogel P. Whiteman’sthings: traininganddetraining- healers in Ghana. HetSpinhuis, Amsterdam 1996.
- World HealthOrganization (WHO). Thepromotion- and Development of TraditionalMedicine. TRS No.622, WHO, Geneva 1978.
- Doğan A, Sungur I, Bilgiç S, Uslu M, Atik B, Tan O, et al. Amputations in eastern Turkey (Van): a multicenter epidemiological study. [Article in Turkish] Acta Orthop Traumatol Turc 2008;42:53–8.
- Naddumba EK. Musculoskeletal trauma services in Ugan- da. Clin Orthop Relat Res 2008;466:2317–22.
- Onuminya JE. Performance of a trained traditional bone- setter in primary fracture care. S Afr Med J 2006;96:320– 2.
- Vukasinović Z, Spasovski D, Zivković Z. Musculoskel- etal trauma services in Serbia. Clin Orthop Relat Res 2008;466:2337–42.
- Ariës MJ, Joosten H, Wegdam HH, van der Geest S. Fracture treatment by bonesetters in central Ghana: pa- tients explain their choices and experiences. Trop Med Int Health 2007;12:564–74.
- Butt MF, Dhar SA, Gani NU, Kawoosa AA. Complica- tions of paediatric elbow trauma treatment by traditional bonesetters. Trop Doct 2009;39:104–7.
- Agarwal A, Agarwal R. The practice and tradition of bonesetting. Educ Health (Abingdon) 2010;23:225.
- Ersoy N. Bursa tıbbi folklorunda kırık-çıkıkla ilgili tedavi yöntemlerinden örnekler ve modern tıp bakımından bazı sonuçlar. Yüksek Lisans Tezi. Uludağ Üniversitesi, Sağlık bilimleri enstitüsü, Deontoloji ve Tıp Tarihi Anabilim Dalı Bursa 1986.
- Bamidele JO, Adebimpe WO, Oladele EA. Knowledge, attitude and use of alternative medical therapy amongst urban residents of Osun State, southwestern Nigeria. Afr J Tradit Complement Altern Med 2009;6:281–8.
- Dada AA, Yinusa W, Giwa SO. Review of the practice of traditional bone setting in Nigeria. Afr Health Sci 2011;11:262–5.
- Wilson JN. Iatrogenic gangrene in the Third World. Trop Doct 1991;21:137–8.
- Ofiaeli RO. Complications of methods of fracture treat- ment used by traditional healers: a report of three cases necessitating amputation at Ihiala, Nigeria. Trop Doct 1991;21:182–3.
- Onuminya JE, Onabowale BO, Obekpa PO, Ihezue CH. Traditional bone setter’s gangrene. Int Orthop 1999;23:111–2.
- OlaOlorun DA, Oladiran IO, Adeniran A. Complications of fracture treatment by traditional bonesetters in south- west Nigeria. Fam Pract 2001;18:635–7.
- Nunes B, Esteves MJ. Therapeutic itineraries in rural and urban areas: a Portuguese study. Rural Remote Health 2006;6:394.
- Ogunlusi JD, Okem IC, Oginni LM. Why patients pa- tronize traditional bone setters. Internet J Orthop Surg 2007;4.
- Dada A, Giwa SO, Yinusa W, Ugbeye M, Gbadegesin S. Complications of treatment of musculoskeletal injuries by bone setters. West Afr J Med 2009;28:43–7.
- Thanni LO. Factors influencing patronage of traditional bone setters. West Afr J Med 2000;19:220–4.
- Solagberu BA. Long bone fractures treated by traditional bonesetters: a study of patients’ behaviour. Trop Doct 2005;35:106–8.
Ayrıntılar
| Birincil Dil | İngilizce |
|---|---|
| Konular | Sağlık Kurumları Yönetimi |
| Bölüm | Orijinal Makale |
| Yazarlar | |
| Yayımlanma Tarihi | 19 Ağustos 2015 |
| Yayımlandığı Sayı | Yıl 2015 |