It was not all about writing a research paper or a case report. This time it was writing our experience regarding mismanagement of simple injuries or fractures by quacks (Figure 1).

Figure 1: 40 year old male had simple patella fracture was advised TBW. However patient refused surgery and went to a quack who applied these threads over the patella. look at gross swelling of limb and blisters over the patella.

Lots of patients frequently come to our orthopaedic OPD with complaints of deformities (Figures 2 and 3), stiffness of joint, non union of fractures or an ugly swelling. It is not uncommon to see patient left handicapped by a quack after a simple fracture. Not only do these quacks treat injuries but they also put their hands on other orthopaedic ailments like rheumatoid arthritis. Most of time history is same.

Figure 2: This case was simple case of fracture distal end radius was maltreated by quack for 2 years in the form of traditional splints and massage. Look at damage to wrist and nonunion of fracture.

Figure 3: This case was 30 year old female had effusion in knee secondary to rheumatoid arthritis. Patient was put on DMARD and was advised regular follow up on OPD basis however patient went to a Quack who aspirated knee at 3 places by some sharp nail. Patient landed up in septic arthritis of knee.

History of trauma sustaining injury to limbs and often injury is of 5 to 6 months old. Usually the patients are form lower socioeconomic group.

The so called different treatment tactics by these quacks keeps on puzzling you and make your work even difficult. The outcome is now further complicated if these cases reach late, after initially getting treatment from “Quacks” in the form of massage and traditional manipulations [1].

A quack is an unqualified person, who claims publically to have medical knowledge and skill which in fact he does not have. Quackery is a promotion of ignorant medical practice given by ignorant person to general public. Unfortunately these quacks do not undergo any basic training apart from obsolete techniques which are secretly handed form father to son and this tradition usually run from generation to generation without any scientific basis.

In developing nations Traditional Bonesetters (TBSs) treat lot of fractures. However, despite high patronage the TBS remains an untrained quack whose practice is often associated with lot of complications and high morbidity [2,3].

Common features of general quackery include questionable or ineffective diagnosis and pseudo management of injuries or fractures. Injudicious massage and application of herbal oil with traction and splintage is all about treatment given by quack. Quack treatment increases the risk of infection, deformities, non unions, malunion or gangrene due to vascular injury.

Very rarely patient is lucky if he escapes these complications. Many people go to traditional bone setter when they are being told by orthopaedicians that surgery is only option for the management. And above all when a small child is brought to hospital by parents who try to do everything they can to avoid surgeries on their wards. These patients usually fall prey to a quack for native treatment which usually lands up in life time disability.

This trend of seeking treatment from bone setters or quacks can be understood in remote areas where health care facility is not available but question remains an issue of concern why educated persons and people hailing from cities seek help of a Quack for their ailment.

Many well to do people explain such treatment by stating that practices such as osteopathy and chiropractic based on manipulation of spine and joints are very popular in West but unfortunately our indigenous quacks have no basic knowledge or training.

Trauma still remains to be neglected and we see unqualified quacks treating a major fracture with traction, massage or application of oil etc. resulting in lifelong misery to the patient. So it is a paradoxical situation but it is the right of every citizen of this large democratic world to be provided the sound basic orthopedic and trauma care. This can be achieved only by restructuring, redefining the medical education at large and orthopedic education in particular.

It is rather horrific that even in 21st century lot of people do not know that there are no special herbs or spirit that draws and align fractures. Bone heals by the intrinsic natural property that God gave to every tissue when the favorable environment is provided. Complication may occur even in hands of experts but are more commonly seen when injuries are mismanaged by quack [2,4-9].

It appears that if we cannot stop Quacks from treating patients at least training TBSs can reduce morbidity rates following TBS treatment. There is a need to educate and train the TBS in effective management of both open and closed fractures. Such training should be provided by orthopedic surgeons with a view to minimizing mismanagement of fractures and prevent complications [2,4,5].

But till date Maltreatment by Quacks is Still an Issue of Concern and debatable issue.