Vol. 11, Issue 4 (2025)

Traditional bone setting is widely practiced in many African countries, including Mali, as the first line of care for fractures. While culturally embedded, its impact on subsequent surgical outcomes remains unclear. This study aimed to evaluate whether prior traditional fracture treatment increases the risk of postoperative complications. We conducted a prospective, monocentric, case-control study over 24 months (July 2017 - July 2019) including 60 patients with limb fractures. Thirty cases underwent osteosynthesis following traditional treatment, and 30 controls received direct surgical management without prior traditional care. Cases and controls were matched for age, sex, fracture type, and osteosynthesis method. Sociodemographic, clinical, and postoperative outcomes were collected. Statistical analysis was performed using SPSS v20, with significance set at p < 0.05. The mean age was 37.7 years (range: 5-71), with a predominance of males (66.7%). The most affected segment was the lower limb (73.3%), primarily femur and tibia fractures. In the case group, the median delay from trauma to surgery was 26 days (range: 3-732), while all controls were operated within 21 days. Postoperative complications occurred in 33.3% of cases versus 6.7% of controls (p < 0.001). Complications included surgical site infection, embolism, displacement, neurapraxia, and pseudarthrosis. Family recommendation and cultural beliefs were the main reasons for choosing traditional treatment. Prior traditional bone setting significantly increases the risk of postoperative complications in limb fractures. Early surgical intervention without prior traditional manipulation may reduce morbidity.