Results of the Traditional Treatment of Fractures of Patients Discharged against Medical Advice from the Orthopedics Department of the Ouahigouya Regional University Hospital (Burkina Faso)

Abstract

Introduction: Binding retains an important place in Africa. Leaving a health facility to see a bonesetter is common there, but a source of complications. The purpose of this work was to analyze the results obtained by bonesetter after discharge against medical advice. Methodology: Analytical cross-sectional study over a period of one year, including all patients admitted for limb fracture, discharged against medical advice for treatment with a bonesetter. Results: Thirty-nine patients were selected. The average age was 36.9 years, and the sex ratio was 5.50. The fractures were open in 35.9%. At a mean follow-up of 19 months, the course was marked by pain in 34.4% and inequality in limb length in 62.5%. Thirteen fractures (40.6%) were consolidated with axis defect, and 11 were without axis defect (34.4%). There were eight non-union (25%), and eleven patients (34.4%) presented with stiffness in one or more joints. Seven patients had died. Discussion: The problem of discharge against medical advice is found in all hospitals but is particularly marked for fractures in our context. The absence of an X-ray and ignorance of the rules of asepsis lead to complications. Only the fractures of the two bones of the leg had progressed well (5/8 good results). The rate of vicious calluses (40.6%) and non-union (25%) is high. Conclusion: Although a few cases have progressed favorably, the results of patients traditionally treated after discharge against medical advice are generally poor.