Abstract
Purpose: The purpose of the study was to perform a retrospective analysis of fractures and dislocations caused by chiropractors in South Africa.
Method: An online survey was distributed to the Allied Health Profession Council of South Africa's database, inviting all registered chiropractors to partake in the survey by use of an email. The participants received an information letter, which explained the anonymity and confidentiality, as well as the fact that their participation were voluntary. Participant's consent was automatically recorded by clicking on the link to the survey. The survey consisted of three sections involving the chiropractor demographics, detail regarding the fracture or dislocation and patient information. Once the survey was completed, participants submitted the survey and results were analyzed by the University of Johannesburg's statistics program (STATKON).
Results: The retrospective analysis revealed that South African chiropractors had caused fractures and dislocations. The percentage of chiropractors who had caused a fracture or dislocation was 14% (18 participants) and resulted in full recovery in all case reports. This indicates that the extent of injury was minor and did not cause long term complication. More specifically, 1 fracture occurred in the treatment of every 1382 patients. With regards to dislocations, 1 dislocation occurred in every 8639 patients treated.
95.5% of fractures were found along the ribs. Fractures were caused by spinal manipulative therapy and dislocations were caused by mobilization techniques. Taking note that 80% of the patients had osteoporosis. Also, the majority of patients were over the age of 50 (79.2%). Clinical signs and symptoms were used as diagnostic method by 14 participants (60.9%).
Conclusion: The chiropractic profession should take these findings into consideration when presented with similar cases. Altering the force used during posterior to anterior thoracic manipulation and lumbar side posture manipulation in patients over 50 or rather using mobilizations in such cases, might decrease the risk of fractures and dislocations occurring in the future. The location of fractures and dislocations mainly occurred at the ribs. Therefore, care should be taken when manipulating or...