{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T23:43:26Z","timestamp":1788479006256,"version":"build-2803163510"},"reference-count":20,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"C","license":[{"start":{"date-parts":[[2025,5,1]],"date-time":"2025-05-01T00:00:00Z","timestamp":1746057600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2025,5,1]],"date-time":"2025-05-01T00:00:00Z","timestamp":1746057600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"},{"start":{"date-parts":[[2025,3,28]],"date-time":"2025-03-28T00:00:00Z","timestamp":1743120000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2025,5]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction and importance:<\/jats:title>\n                    <jats:p>Traditional bone setting (TBS) is commonly practiced in many communities worldwide, especially in developing countries in Asia, South America, and Africa, where healthcare resources are less developed. It plays an important role in healthcare delivery systems and remains a widely used alternative to modern medical care for limb fractures. This practice involves using wooden straps and casts to immobilize and stretch the injured limb, often leading to complications such as non-union, malunion, infections, compartment syndrome, and even limb amputations.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case presentation:<\/jats:title>\n                    <jats:p>We discuss a case of a 30-year-old male patient who arrived at our facility with infected and gangrenous forearm with compartment syndrome following a week after traditional bone-setting intervention. The patient required an urgent fasciotomy and extensive surgical debridement of necrotized tissues. Due to extensive tissue loss, ischemia, gangrene, and persistent limb hypoesthesia and paresis, a forearm amputation was ultimately performed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Clinical discussion:<\/jats:title>\n                    <jats:p>The traditional bone setter is a lay practitioner of joint manipulation, often lacking formal medical training. Despite the availability of modern healthcare systems, traditional bone setting continues to be widely used in many communities, leading to severe complications when improperly performed. In rural areas, traditional healers may not have the necessary knowledge to manage limb fractures appropriately, resulting in inflammation, infections, and delayed treatment. Strengthening healthcare delivery requires additional training for traditional healers and increasing public awareness about trauma care and early hospital referrals.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>While traditional bone setting holds cultural significance, it poses serious risks, including infection, gangrene, and limb amputation, as demonstrated in this case. This report highlights the urgent need for community education, improved trauma awareness, and enhanced integration of safe, evidence-based fracture management in rural settings to prevent such complications and improve patient outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Highlights<\/jats:title>\n                  <\/jats:sec>","DOI":"10.1016\/j.ijscr.2025.111237","type":"journal-article","created":{"date-parts":[[2025,4,1]],"date-time":"2025-04-01T10:02:57Z","timestamp":1743501777000},"update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":2,"title":["Loss of a limb: A consequence of traditional bone setting"],"prefix":"10.1097","volume":"130","author":[{"given":"Dennis","family":"Machaku","sequence":"first","affiliation":[{"name":"Department of General Surgery, Catholic University of Health and Allied Sciences, PO Box 1464, Mwanza, Tanzania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jay","family":"Lodhia","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amani","family":"Nangole","sequence":"additional","affiliation":[{"name":"Department of Orthopedics and Trauma, Kilimanjaro Christian Medical Centre, PO Box 3010, Moshi, Tanzania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kondo","family":"Chilonga","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Honest","family":"Massawe","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"issue":"10","key":"R2-18-20260304","doi-asserted-by":"crossref","first-page":"2392","DOI":"10.1007\/s11999-008-0371-8","article-title":"The practice of traditional bonesetting: training algorithm","volume":"466","author":"Omololu","year":"2008","journal-title":"Clin. Orthop. Relat. Res"},{"issue":"8 I","key":"R3-18-20260304","first-page":"652","article-title":"The role of the traditional bonesetter in primary fracture care in Nigeria","volume":"94","author":"Onuminya","year":"2004","journal-title":"South African Med J"},{"issue":"10","key":"R4-18-20260304","doi-asserted-by":"crossref","first-page":"1431","DOI":"10.1053\/jpsu.2000.16406","article-title":"Bone setter's gangrene","volume":"35","author":"Bickler","year":"2000","journal-title":"J. Pediatr. Surg"},{"issue":"5","key":"R5-18-20260304","first-page":"1136","article-title":"The SCARE 2023 guideline: updating consensus Surgical CAse REport (SCARE) guidelines","volume":"109","author":"Sohrabi","year":"2023","journal-title":"Int J Surg Lond Engl [Internet]"},{"issue":"1","key":"R6-18-20260304","doi-asserted-by":"crossref","first-page":"418","DOI":"10.4314\/ahs.v21i1.52","article-title":"Patient patronage and perspectives of traditional bone setting at an outpatient orthopaedic clinic in northern Tanzania","volume":"21","author":"Card","year":"2021","journal-title":"Afr. Health Sci"},{"issue":"1","key":"R7-18-20260304","first-page":"342","article-title":"Fracture Management in Traditional Indian Medicine","volume":"10","author":"Toshikhane","year":"2009"},{"issue":"3","key":"R8-18-20260304","article-title":"Why do people prefer traditional bonesetters in Sudan? Sudan","volume":"5","author":"Idris","year":"2010","journal-title":"J. Med. Sci"},{"issue":"6","key":"R9-18-20260304","doi-asserted-by":"crossref","first-page":"1","DOI":"10.9734\/AIR\/2018\/41744","article-title":"Extremity amputations in children from complications of traditional bone Setters' Care seen in a tertiary Hospital in Port Harcourt","volume":"14","author":"Diamond","year":"2018","journal-title":"Nigeria. Adv Res"},{"issue":"2","key":"R10-18-20260304","first-page":"91","article-title":"Consultation of traditional bone setters instead of doctors: is it a sociocultural and educational or social insurance problem?","volume":"45","author":"G\u00f6lge","year":"2015","journal-title":"Trop. Dr"},{"issue":"I","key":"R11-18-20260304","first-page":"159","article-title":"sorununa b\u00f6lgesel (Sivas y\u00f6resi anket)","author":"Kelimeler","year":"1990"},{"issue":"1","key":"R12-18-20260304","doi-asserted-by":"crossref","first-page":"142","DOI":"10.1186\/s12906-023-03951-8","article-title":"Traditional bone setting service users and associated factors among people with trauma in Mecha district, Ethiopia","volume":"23","author":"Endeshaw","year":"2023","journal-title":"BMC Complementary Medicine and Therapies"},{"issue":"1","key":"R13-18-20260304","article-title":"The continued role of traditional bonesetters in east and West Africa: an expert consensus statement. East and central African","volume":"28","author":"Askew","year":"2023","journal-title":"J. Surg"},{"issue":"1","key":"R14-18-20260304","doi-asserted-by":"crossref","first-page":"102","DOI":"10.1302\/0301-620X.87B1.15585","article-title":"The prevention of traditional bone setter's gangrene","volume":"87","author":"Eshete","year":"2005","journal-title":"J. Bone Joint Surg. (Br.)"},{"issue":"2","key":"R15-18-20260304","doi-asserted-by":"crossref","first-page":"194","DOI":"10.18203\/issn.2455-4510.IntJResOrthop20210613","article-title":"Traditional bone setting: an avoidable cause of major limb amputations","volume":"7","author":"Salihu","year":"2021","journal-title":"Int. J. Res. Orthop"},{"issue":"3","key":"R16-18-20260304","doi-asserted-by":"crossref","first-page":"365","DOI":"10.1016\/S0749-0712(21)00395-4","article-title":"Causes of upper extremity compartment syndrome","volume":"14","author":"Yamaguchi","year":"1998","journal-title":"Hand Clin"},{"issue":"3","key":"R17-18-20260304","doi-asserted-by":"crossref","first-page":"229","DOI":"10.1111\/os.12054","article-title":"Upper arm compartment syndrome: a case report and review of the literature","volume":"5","author":"Maeckelbergh","year":"2013","journal-title":"Orthop. Surg"},{"issue":"3","key":"R18-18-20260304","first-page":"263","article-title":"Factors associated with development of traumatic acute compartment syndrome: a systematic review and meta-analysis","volume":"9","author":"Mortensen","year":"2021","journal-title":"Arch. Bone Jt. Surg"},{"issue":"3","key":"R19-18-20260304","doi-asserted-by":"crossref","first-page":"231","DOI":"10.1016\/j.ocl.2021.03.005","article-title":"Cast-Related Complications","volume":"52","author":"Drake","year":"2021","journal-title":"Orthop Clin North Am [Internet]"},{"key":"R20-18-20260304","first-page":"1","article-title":"Traditional medicinal plant knowledge and use by local healers in Sekoru District, Jimma zone","volume":"3","author":"Yineger","year":"2007","journal-title":"Southwestern Ethiopia. J. Ethnobiol. Ethnomed"},{"issue":"3","key":"R21-18-20260304","doi-asserted-by":"crossref","first-page":"151","DOI":"10.1111\/j.1445-2197.2010.05213.x","article-title":"Clinical practice guidelines for the management of acute limb compartment syndrome following trauma","volume":"80","author":"Wall","year":"2010","journal-title":"ANZ J. Surg"}],"container-title":["International Journal of Surgery Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S2210261225004237?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S2210261225004237?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.lww.com\/10.1016\/j.ijscr.2025.111237","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,4]],"date-time":"2026-03-04T10:01:57Z","timestamp":1772618517000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.lww.com\/10.1016\/j.ijscr.2025.111237"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,5]]},"references-count":20,"journal-issue":{"issue":"C","published-print":{"date-parts":[[2025]]}},"URL":"https:\/\/doi.org\/10.1016\/j.ijscr.2025.111237","relation":{},"ISSN":["2210-2612"],"issn-type":[{"value":"2210-2612","type":"print"}],"subject":[],"published":{"date-parts":[[2025,5]]},"assertion":[{"value":"2025-02-07","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-03-28","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}