What are the orthopedic disasters of bone-setters among patients admitted to the trauma emergency department of a Sahelian hospital?

to the study: Fractures overlooked or initially seen by bone-setters constitute a real management problem in the Sahelian orthopedic setting. We conducted a prospective study to determine: 1) whether access to specialized care influences the choice of traditional treatment; 2) whether the high cost of hospital care in Niger influences the use of bone-setters? Could identifying these problems, which undermine society, help to end the fear of Nigerien orthopedists? Are these orthopedic disasters linked to the precariousness of the environment? We report here a prospective descriptive cohort over a 5-year period, from June 2020 to June 2025, involving patients hospitalized for orthopedic injuries. During the study period, 251 patients were registered; 13 were presented with severe comorbidities, 7 refused consent, and 2 died during hospitalization, leaving 251 patients who had experienced orthopedic complications. A survey form containing sociodemographic information, the reason for conventional treatment, and the initial injury served as the basis for assessing our patients. Epi-info.7 software was used for data entry and analysis. A description of the sample was provided as a percentage proportion. Data quality assurance was ensured through data cleaning, and no missing data were observed. In our series, we collected 251 cases over a 5-year period. The annual incidence ranges from 23 to 83 cases, with an average of 58 cases per year. There was a very strong male predominance, with 200 patients representing 79.68% of the cases, with a sex ratio of 3.92. The consultation delay was 182 days, with extremes ranging from 60 days to 2 years. Vicious malunions accounted for 60 cases (23.9%). Nonunions accounted for 40 cases (15.9%). Length discrepancies were observed in 25 patients (10.0%). Stiffness in 30 cases (11.9%). Chronic osteomyelitis in 35 cases (13.9%). Bone-setters are the first port of call for fractures. This is a medical culture linked to the people, the causes of which are not generally understood in Niger. IV, clinical series, prospective.