Traumatic cubitus valgus consequent of distal humeral fracture: Two case studies from the Holocene Later Stone Age in southern Africa

IF 1.3 3区 地球科学 Q3 PALEONTOLOGY International Journal of Paleopathology Pub Date : 2023-08-29 DOI:10.1016/j.ijpp.2023.07.001
Calvin G. Mole , Deano D. Stynder , Victoria E. Gibbon
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Abstract

Objectives

Distal fractures of the humerus and their complications have rarely been described or analysed in the palaeopathological literature. The objective of this study was to evaluate two cases of distal humeral fracture with associated cubitus valgus observed in two individuals from the context of the Later Stone Age (LSA) in southern Africa.

Materials

Skeletal remains of two individuals. A middle-aged female radiocarbon dated to c.160 BP and a middle-aged male radiocarbon dated to c.2 300 BP.

Methods

Remains were macroscopically and radiographically assessed for injury.

Results

Both cases presented with healed antemortem injury to the right elbow attributed to possible falls. Distal humeral fracture resulted in non-union of the lateral epicondyle with extensive morphological changes to the elbow joint including an increased carrying angle. Morphological and osteoarthritic changes suggest a survival period of several years post-injury.

Significance

Cubitus valgus following traumatic injury has rarely been reported amongst historic or prehistoric populations. The described injuries would have had physical and functional consequences, raising questions relating to probable care received during the healing process. The elbow injuries would have resulted in restricted motion and instability of the elbow joint, with a high likelihood of ulnar neuropathy.

Limitations

The contextual information for these individuals is limited and do not permit broader population level study.

Suggestions for further research

Formal biomechanical analysis including cross-sectional geometry analysis will provide further information regarding complications and strengthen the diagnosis of ulnar neuropathy. Further research is necessary on the prevalence and complications of humeral fracture.

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肱骨远端骨折所致外翻外翻:非洲南部全新世晚期石器时代的两个案例研究
目的:肱骨远端骨折及其并发症在古病理学文献中很少被描述或分析。本研究的目的是评估两例肱骨远端骨折合并肘外翻的病例,这两例患者来自非洲南部晚石器时代(LSA)的背景。材料:两具遗骸。一个中年女性的放射性碳测年可追溯到公元前160年BP和一名中年男性放射性碳测年约2 300 BP。方法对残肢进行宏观和影像学检查。结果两例患者死前右肘损伤均已愈合,原因可能是跌倒。肱骨远端骨折导致外侧上髁不愈合,肘关节发生广泛的形态改变,包括携带角度增加。形态学和骨关节炎的变化表明损伤后的生存期为数年。在历史或史前人群中,外伤后外翻的报道很少。所描述的损伤会造成身体和功能上的后果,这就提出了有关在愈合过程中可能得到的护理的问题。肘部损伤会导致肘关节运动受限和不稳定,尺神经病变的可能性很高。局限性:这些个体的背景信息是有限的,不允许更广泛的群体水平研究。正式的生物力学分析包括横截面几何分析将为并发症提供进一步的信息,并加强尺神经病变的诊断。肱骨骨折的患病率及并发症有待进一步研究。
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来源期刊
CiteScore
2.90
自引率
25.00%
发文量
43
期刊介绍: Paleopathology is the study and application of methods and techniques for investigating diseases and related conditions from skeletal and soft tissue remains. The International Journal of Paleopathology (IJPP) will publish original and significant articles on human and animal (including hominids) disease, based upon the study of physical remains, including osseous, dental, and preserved soft tissues at a range of methodological levels, from direct observation to molecular, chemical, histological and radiographic analysis. Discussion of ways in which these methods can be applied to the reconstruction of health, disease and life histories in the past is central to the discipline, so the journal would also encourage papers covering interpretive and theoretical issues, and those that place the study of disease at the centre of a bioarchaeological or biocultural approach. Papers dealing with historical evidence relating to disease in the past (rather than history of medicine) will also be published. The journal will also accept significant studies that applied previously developed techniques to new materials, setting the research in the context of current debates on past human and animal health.
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