Oral Presentation- Kirushanth kirushanth sathiyanathna

Its a oral
Presentation about a case presented

1. Perceptions regarding traditional bone setting among patients with fractures in National Hospital of Sri Lanka

2. Kirushanth Sathiyanathan , Postgraduate Institute of Medicine, University of Colombo Senuri Dias, Accident and Emergency, District General Hospital Avissawella Nissanthan Tharmakulasingham , Postgraduate Institute of Medicine, University of Colombo Chrishan Navarathnam , Postgraduate Institute of Medicine, University of Colombo Authors

3. Introduction Traditional medicine has deep historical roots and often coexists with modern healthcare in low- and middle-income countries. Fractures are a major global health issue, and while modern orthopaedics offers advanced care, traditional bone setting remains widely used. In Sri Lanka, traditional fracture care ( Kedum Bindum Wedakama ) involves natural materials like bamboo and tree bark. Factors such as affordability , cultural beliefs , fear of surgery , and long hospital wait times influence the choice of traditional care. However, complications from traditional treatments are common and can be severe, often requiring complex surgical intervention. Despite this, traditional bone setting remains popular, highlighting the need to understand patient preferences.

4. To determine the perceptions regarding traditional bone setting both qualitatively and quantitatively among patients with fractures treated at orthopaedic surgery clinics and wards at National Hospital of Sri Lanka (NHSL). Objectives

5. Design : Descriptive cross-sectional study Setting : Orthopaedic clinics, wards, and Accident Service Ward at National Hospital of Sri Lanka (NHSL) Study Population : Patients with fractures/ orthopaedic ailments treated at NHSL Inclusion Criteria : Receiving orthopaedic treatment at NHSL Resident of Sri Lanka Able to provide informed consent Exclusion Criteria : Major psychiatric disorders Cognitive impairment Methods

6. Sampling Method : Consecutive sampling Sample Size : 100 participants Data Collection Tool : Self-administered questionnaire Duration : 1 month Ethical Approval : NHSL Ethics Review Committee Analysis : IBM SPSS Statistics v30.0 Methods

7. Age Distribution : Majority (27%) were aged 60–69 years (Mean age: 52.67 years) Primary Reason for Seeking TBS: Chronic pain – 50% of respondents Main Motivators for Choosing TBS: Cultural beliefs, Better accessibility, recommendations Results

8. Complications from TBS: Reported by 15% of respondents Most common complication: Exacerbation of pain (40%) Reason for Seeking Formal Healthcare: Sophisticated imaging availability (98%) Perceptions of TBS vs. Orthodox Care: 50% were undecided about the skill level of traditional bone setters 50% believed orthodox care is more effective for pain and wound management 65% believed orthodox care is not more expensive than TBS

9. Traditional bone setting (TBS) remains a widely relied-upon practice in Sri Lanka for orthopaedic care. Cultural beliefs, recommendations by someone, and accessibility are key reasons for continued TBS use. Free public healthcare and advanced diagnostics are encouraging a gradual shift toward orthodox medical care. Key limitations: Selection bias – recruited at orthodox care centre after failed or some sort of complication following TBS Single-centre small sample urban setting - more like urban population who can access hospital Recommendations: Standardize and regulate TBS through training programs and safety guidelines. Strengthening collaboration between TBS practitioners and orthodox healthcare providers, such as through effective referral systems . Improve the accessibility of orthodox treatment to public Conclusions

10. Thank You