Bone Setting

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Traditional bone-setting (tajbir al-kusur) depends on the manipulative reduction of broken bones, external fixation with splints or with a functional brace that provides limited immobilization of a fracture site and mobilization of other joints. This way, the patient, through the movements that are possible, exercises the limb.

Broken bones are set with tabb or jabiras (splints). These are varying lengths and sizes of wood in sets of four, firmly tied around the site of the fracture with strings or date palm fronds after padding it with cloth. This method has changed very little over the years. Identical splints have been found in an Egyptian mummy of the fifth dynasty (circa 5000 years ago) at Nga Ed-Der 100 miles from Luxor.

It is equally true that bone-setting, has been accompanied by several complications, some of them serious. This is to be expected because many healers are ignorant of anatomy and modern techniques of the craft. Their shortcomings are particularly exposed when they try setting compound fractures, spinal cord injuries, and difficult fractures such as supracondylar ones. The most common complications include non-union, mal-union, Volkmannís contractures and gangrene of the extremities.

Closed soft tissue injuries can result from falls, blows, collisions and compressions. They give rise to crushed parts, sprains, contusions or more serious injuries. All are managed with massage and manipulation using a variety of oils, ointments, poultices and bandaging, as well as rest.

In countries where the skills of traditional bone-setting are integrated with systems of biomedical diagnosis and management, the average period of the clinical union of broken bones has been significantly shorter and the complications of fracture treatment (joint stiffness, muscular atrophy, osteoporosis, delayed union or non-union) largely eliminated. It has been suggested that traditional and biomedical skills be integrated in the management of various fractures of limbs, the spinal column and most intra-articular fractures, fresh or cold, closed, open or infected.[1]

[1] Western Tienyu, Shang. Treatment of fracture and soft tissue injury by integrated methods of traditional Chinese and medicine. In: Bannerman, R.H, editors. Traditional Medicine and Health Care Coverage. Geneva: WHO; 1983: 86-9.

 


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