Brief Updates: A Possible Publishing Rule of Thumb, Socio-Sexual Lives in Bioarchaeology & Memories of Fractures

I’ve been thinking a bit recently about the power of the written word, and of the associations with both personal jottings and more wider ranging long form pieces such as academic text books or investigative journalism.  Partly this has been guided by the growing number of books on my bedside, but also by a personal milestone in the publication of a bioarchaeology chapter by yours truly.  I’ll try not to mention this too much but it has been, and it will be, the realisation of a dream of mine to become a published author and particularly so in a topic that is close to my professional and personal interests.  But more on that below.

Two of the texts discussed in this entry below are Ann Oakley’s part memoir and part sociology study in Fracture: Adventures of a Broken Body and Pamela Geller’s research into socio-sexual lives in the archaeological record, which investigates past human sexuality.

Publishing: The Invisible Researchers

The term Publish or perish is a popular and well-known academic phrase that highlights the fact that research that isn’t published appropriately, or in a relatively timely manner, can easily become lost to the archives and the relevancy of the researcher to their discipline to disappear.  Any academic employed at an educational institute and conducting research will likely regularly produce articles, chapters, and books as appropriate, and actively take part in conferences giving papers or leading workshops to disseminate and communicate knowledge.  This is a normal part of the workload (heavy though that can be) of a research position.

Whether that phrase is helpful or stressful depends on the context – rushed research can lead to false or doctored evidence and the increased pressure to publish, along with the normal duties of lecturing, likely being a course or module tutor, and the administration accompanying such positions, can indeed lead to a hefty work load.  My interest in this though is the invisible researchers who are not employed within academia but are located on the fringes, those such as myself who work full-time in other sectors and publish and research in our own free time.  This blog is a prime example of that, but also of the mixing of the boundaries between the personal and the academic which would not normally be found within journals or published volumes.  Rather this is space to inform, educate, and communicate the interests and experiences of the individual.  The published work, of which I have only a few examples currently with more emphasis currently on specialist reports, requires a change of tone and, often, of approach.

Publishing Date Rule of Thumb?

I’ve also recognised a relatively reliable rule of thumb for academic book publishing.  For instance, I’ve been eagerly awaiting the publication of my own chapter within an edited volume titled New Developments in the Bioarchaeology of Care: Further Case Studies and Theory, to be published as a part of Springer’s Bioarchaeology and Social Theory series.  The edited volume builds upon Lorna Tilley’s 2015 Theory and Practice in the Bioarchaeology of Care publication in identifying and interpreting cases of care provision in prehistory through osteological and contextual analysis, and by furthering the theoretical framework.  It is exciting to a part of such a volume as a result of the SAA session in 2015 and I’m keen to hold a copy of the finished work and to read the other authors contributions.  I’m also intrigued by the reception that the volume will hopefully receive and the criticism too, with the opportunity to learn from others in the field of bioarchaeology.

But the rule of thumb!  Springer obviously mentions their forthcoming volumes on their site as do other commercial online retailers, however I’ve noticed they tend not to add a specific date for publication whereas some retailers, such as Amazon, do under the title release date (1).  This is useful to know as the publishing date tends to change depending on when the individual chapter and volume editing and proof-reading tasks have been completed, and as to when the publishing production units can start to print.  In my case I’ve noticed the dates shift around a few times due to various factors but I’ve always known when roughly publication and release date should be, sometimes ahead of emails from the volume editors.  Of course this won’t really be a rule of thumb until the volume is published and collaborates my theory, but you can expect another blog post then!  If you have noticed the same trend please let me know below.

Socio-Sexual Lives In Bioarchaeology

Through serendipity I happened to come across Pamela Geller’s 2016 book The Bioarchaeology of Socio-Sexual Lives: Queering Common Sense About Sex, Gender, and Sexuality, published in the same Bioarchaeology and Social Theory series by the above and due for release shortly.  I am very tempted to order a copy of this volume as it seems to challenge the binary orthodoxy of sexuality and identity so prevalent within bioarchaeological analysis of past individuals and populations.  That is an interrogation of the assumption of stability with regards to the values of hetero-normative relations within today’s Western world that is so often projected onto past populations and cultures.

The wide range of cultural case studies and the deep chronological scope of the volume also promises to make it be an invigorating and exciting read.  As with the Bioarchaeology of Care publication, this volume probes the archaeological record into areas of research that have rarely been investigated in-depth, thus potentially opening up the record to a far greater scrutiny of the lived experience of sexual identity and gender.  As such, it is very much on my bioarchaeological books to read next list (you know, after I’ve read this other pile of books by my bedside table!).  It isn’t very often that I purchase bioarchaeology volumes as they can be quite expensive if they are not available in paperback or second-hand (2), but I’ll think I’ll make a change for this volume.  If I do I’ll be sure to write-up an entry for the blog.

Memories of Fractures

And so to bring this post to a timely conclusion I return to my opening paragraph.  One of my favourite books that I’ve had the pleasure of reading within the past few years remains the sociologist Ann Oakley’s (2007) Fracture: Adventures of a Broken Body, an essay on the impact of the author’s traumatically fractured humerus that covers much ground within a relatively slim volume.  I largely adore this book because it is so relatable and so readable, the descriptions of the personal and professional impact of her fracture is something that I can very much sympathize and empathize with.  However the strength is also the breadth of the book, through the historical, medical and sociological musings on the frailty, health and image of the human body and entwined identity.  This volume then represents a fine mix of the personal and the academic, never afraid to speak freely on the issues and challenges that face society in accepting the differences in human form and the obstacles.

The Great Questions of Bioarchaeological Research

To me then bioarchaeology and its associated disciplines offers the chance to investigate on a fundamental level one of the central facets of our existence; what does it mean to be human? How is this represented and approached in the archaeological record?  How were individuals treated within their respective populations, and what were the lived experiences of these populations and individuals like?  The ability to answer some of these questions, in part at least, endlessly fascinates me.  Some of the publications named above aim to answer these questions and may do just that.

Notes

(1).  I have just rechecked this and sadly my thumb of thumb can seemingly be thrown out of the window.  It appears that Amazon does seem to have a better rough date for volumes in preparation, but that by the final month or so within publishing and release date Springer also update their website.

(2).  Joining local or university libraries, where possible, can be great to order books in or to borrow books that are otherwise un-affordable or rare to find.  I generally only purchase bioarchaeology manuals that can be used in osteological analysis or are otherwise handy reference books, but otherwise some books can make great presents!

Bibliography

Geller, P. L. 2016. The Bioarchaeology of Socio-Sexual Lives: Queering Common Sense About Sex, Gender and Sexuality. New York: Springer.

Oakley, A. 2007. Fracture: Adventures of a Broken Body. Bristol: Policy Press.

Tilley, L. 2015. Theory and Practice in the Bioarchaeology of Care. New York: Springer.

Four of A Kind: Body Focused Books

There has been a recent spate of publications that will interest the wide variety of professions that study and work with the human body, and a few that will be of major interest to those in the bioarchaeological and anthropological fields who study both the physical remains of the body and the cultural context that these bodies lived, or live, in.  With the annual Christmas celebrations a matter of weeks away, I’d thought I’d highlight a few publications that could potentially be perfect presents for friends and family members who are interested in the human body, from anatomical inspection to the personal introspection of what my body, and yours, can inform us of ourselves and the world around us…

Cover shots of the four books discussed below.

Adventures in Human Being: A Grand Tour from the Cranium to the Calcaneum by Gavin Francis. London: Profile Books (in association with the Wellcome Collection). 

Having previously read Francis’s book on being a doctor in Antarctica and knowing that he has accrued a wealth of knowledge and experience of treating the body from a medical viewpoint in a wide variety of countries, I was intrigued to see this new publication by him, which focuses on different sections of the body as a jumping off point for the essays in this collection.  I’d recently read Tiffany Watt Smith’s The Book of Human Emotions: An Encyclopedia from Anger to Wanderlust (which, coincidentally, is also published by Profile Books and the Wellcome Collection), which introduces over 150 different human emotions in an exciting combination of psychological, anthropological, historical and etymological mini essays on the human condition.

It is a thoughtful book and made me wonder about how we approach the body in bioarchaeology, whether our lexical terminology isolates and intimidates, frustrates and alienates those who we seek to engage and educate.  The Book of Human Emotions succinctly highlighted what we think is the universal, the standard charge sheet of emotions (anger, fear, joy, love, etc.) that can be found in cultures across the world, is actually not quite the case or clear-cut, and that they can be expressed and felt in different ways.  Francis’s book, I think, will also offer something as equally as thought-provoking.  Known not just for his medical expertise but also for the humanity of his writing, Francis’s exploration of the body, as a story we can each call our own, delves into the medical, philosophical and literature worlds to uncover the inner workings of the human body, in good health, in illness and in death.

Crucial Interventions: An Illustrated Treatise on the Principles and Practices of Nineteenth-Century Surgery by Richard Barnett. London: Thames & Hudson (in association with the Wellcome Collection).

I came across the above book purely by chance whilst out browsing bookstores in York recently and I have to say it is now on my festive wish list.  The medical historian Richard Barnett introduces a publication detailing the knowledge and variety of surgical practices available to the 19th century surgeon, focused largely on the presentation of the technical drawings produced in the era as a precise method for communicating the advancements made in a variety of treatments.  The publication introduces some of the earliest effective surgical techniques for dealing with devastating facial and limb injuries, either from disease processes, traumatic incidents or the outcomes of warfare, and documents the procedures used in re-configuring the body to alleviate the pain and the disfigurement suffered from such injuries and traumas.  It may not be for the faint of heart, but I could see that some modern-day surgeons may be interested to learn of past techniques, the tools and resources that they had, and the importance of always improving and building upon the innovations of the past.

Bioarchaeology: An integrated Approach to Working with Human Remains by Debra L. Martin, Ryan P. Harrod & Ventura R. Pérez. New York: Springer.

For any undergraduate or postgraduate student of archaeology that has a burgeoning interest in biarchaeology as a profession, I’d heavily encourage them (and the department) to get a copy of Bioarchaeology: An Integrated Approach to Working with Human Remains by Martin, et al.  The volume concisely introduces the discipline and outlines the background to it, the theories and methodologies that have informed the theoretical and practical application of bioarchaeology, the current state of play with regards to legal and ethical frameworks, and, finally, the impact and the importance of bioarchaeology as a whole.  The volume also uses invigorating case studies to elucidate the methods of best practice and the impact of the points made throughout the volume.  It is an excellent guide to the discipline and well worth purchasing as a reference book.  Furthermore the volume is now out in paperback and it is very handy to have in your backpack, partly as a one stop reference for any theories or methodologies currently used in bioarchaeology but also as a pertinent remainder of the value of what we do as bioarchaeologists and why we do it.

Theory and Practice in the Bioarchaeology of Care by Lorna Tilley. New York: Springer (Hardback only at the moment).

The post before this one has already detailed the aim and scope of this publication but I feel it is worth highlighting here again.  The bioarchaeology of care, and the associated online Index of Care application, aims to provide the bioarchaeologists with the tools for a case study framework for identifying the likelihood of care provision in the archaeological record by providing four stages of analysis in any individual skeleton exhibiting severe physical impairment, as a result of a disease process or acquired trauma.  The methodology takes in the importance of palaeopathology (the identification and diagnosis, where possible, of pathological disease processes in skeletal remains which has a firm basis in modern clinical data) but also the archaeological, cultural, geographic and economic contexts, to examine whether receipt of care is evidenced.

In the publication Tilley documents and investigates a number of prehistoric case studies, ranging from the Upper Palaeolithic to the Neolithic, and determines the likelihood of care and the type of care that was needed for the individuals under study to survive to their age at death.  The theoretical background and implications, alongside the ethical grounding of the methodology and the concerns in terminology, are also documented at length.  Perhaps most importantly, this is a methodology that is open to improvement and to the use within current and future research projects.  It is also a method that can be used first hand when examining skeletal remains or from the literature itself (where available to a good enough standard).

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The above publications are, to me, some of the most interesting that I have seen recently, but I am always on the look out for more.  Please note that the average costs of the books above are within the £10.00-£20.00 range, but prices will vary significantly.  The hardback academic publications can be quite expensive (+ £70), however once the volume is out in paperback the price tends to fall steeply.  If you can recommend anything please let me know in the comments below.

And Finally a Stocking Filler…

The University of Durham is playing host to a one day conference entitled Little Lives, focusing on new perspectives on the bioarchaeology of children, both their life course and their health, for the very fair price of £10.00 on the 30th of January 2016.  The Facebook group for the conference can be found here.  Alternatively contact the conference organizers via the Durham University webpage here to secure a place (something I must do soon!).

Please note that the call for papers date has now passed and that the conference program has now been finalized.

Further Information

• The Wellcome Trust, which helps operate the Wellcome Collection, is an independent global charity foundation dedicated to improving health by funding biomedical research and medical education.  The charity also has a keen focus on the medical humanities and social sciences, and it recognizes the importance of running educational workshops, programs and outreach events.  Find out more information on the charity here.

• Check out Alexandra Ion’s Bodies and Academia blog for her latest post entitled holiday gift ideas for anatomy lovers for more books focused on the human body.  I also highly recommend reading Ion’s blog for insights into understanding the human body in archaeology and osteoarchaeology.  Further to this check out Ion’s really interesting research into the Francisc I. Rainer human osteological collection in Romania, one of Europe’s largest skeletal collections, held at the Anthropology Institute of the Romanian Academy.

A Stone to Throw II: Upcoming Archaeology Conferences

A few dates for the diary as this year sees some pretty exciting archaeology and bioarchaeology themed conferences rolling towards us in the next four months of 2014 or so.  Conferences are fantastic places to learn about new techniques or research approaches in archaeology.  It can also be a thrill watching famed archaeologists and professors speak in the flesh about topics which they are passionate about.  Conferences, depending on their target audience, can sometimes be open to the public and members of academia alike, but they can also vary widely in cost depending on their location, size and prestige.

Without further ado here are a few conferences that have peaked my interest and some that I hope to attend myself (although Istanbul may have to be missed due to an unfortunate clash with BABAO):

Dearne Valley Archaeology Day 2014, Wath-Upon-Dearne

The community focused Elmet Archaeology group, who were recently mentioned here as a part of an interview with their osteoarchaeologist Lauren McIntyre, are hosting their annual Dearne Valley Archaeology Day in Wath-Upon-Dearne, South Yorkshire, on Saturday the 31st of May.  Open to the members of the public and archaeologists alike, the day long conference costs £18 (£14 unwaged) to attend and boasts a host of speakers on a variety of topics.  The full list of speakers has yet to be announced but so far includes British archaeological stalwarts such as David Connolly of BAJR fame, Prof Joan Fletcher of the University of York and a range of speakers from archaeological units across the country.  There will also be a number of stalls on the day, including information booths on how to illustrate archaeology style by Kate Adelade, Dearne Valley Archaeology Group and a stall with Jenny Crangle detailing the medieval Rothwell Charnel Chapel Project (which has been previously discussed on this blog).   

Exploring Changing Human Beliefs About Death, Mortality and the Human Body, Invisible Dead Project Conference, Durham

The University of Durham is playing host to the Invisible Dead Project conference from Friday 6th of to the Sunday the 8th of June.  The conference has two lectures on the Friday and Saturday nights which are open to the public and two full days of talks for students and academics during the Saturday and Sunday daytime.  The conference is, quite wonderfully, completely free to attend.  The ongoing Invisible Dead Project is a large-scale international collaboration aimed at studying the prehistoric and historic attitudes to death and burial of Britain and the Levant areas.  Information and details of sites under study can be found here at the University of Durham webpage.

The conference welcomes anthropologists, archaeologists and members of the public interested in death and  human remains in prehistory and up contemporary society to attend.  The first public speaker is Prof. Peter Pfälzner, from the University of Tübingen, explaining work carried out on long-term royal funerary processes at Qatna, Syria, on Friday night (6.30pm), whilst Prof Mike Parker Pearson discusses problems and perspectives in funerary archaeology on the Saturday night (6.30pm).  If you are interested in attending the conference forms should be completed before the 30th of April.

British association of Biological Anthropologists and Osteoarchaeologists, Durham

The British Association of Biological Anthropology and Osteoarchaeology are holding their annual conference at the University of Durham in September, from Friday 12th to the Sunday 14th.  The three-day conference will feature a broad range of presentations, talks and posters on the great range and wealth of  osteoarchaeology in Britain and beyond.  The call for papers has just been announced and is open until the 9th of June.  Last year’s conference program can be found here.  Although details have not been released just yet of the costs of attending the conference, it is likely that it will upwards of £140 to attend (based on 2013 BABAO member rates).  The information concerning the 4 sessions has just been released and are based around the following clusters:

1) The body and society: past perspectives on the present

2) Biological anthropology and infectious disease: new developments in understanding from bioarchaeology, palaeoanthropology, primatology, and archaeozoology

3) New developments in biomolecular methods

4) Open session

Details on the key-note speakers for each session can be found here, as can further information on conference guidelines for following abstract guidelines and submission dates.  The BABAO conference is the foundation stone of conferences in the UK osteology calendar as it really does represent the best in current research in the UK and beyond.  Although I have yet to attend one (due to costs), I have high hopes of attending this year’s event in the lovely historic (and local to me) city of Durham.

European Association of Archaeologists, Istanbul

The European Association for Archaeologists host their conference in September, from the Wednesday the 10th to the Sunday the 14th, in Istanbul, Turkey.  The call for papers and posters has now closed, but they did receive a very healthy 2400 submissions in total.  The broad topics of discussion for the 2014 session are categorised into 6 different focus areas including:

1) Connecting seas: across the borders

2) Managing archaeological heritage: past and present

3) Ancient technologies in social context

4) Environment and subsistence: the geosphere, ecosphere and human interaction

5) Times of change: collapse and transformative impulses

6) Retrieving and interpreting the archaeology record

The fees for attending the EAA conference ranges in price from €40 to €180 dependent on category of the applicant (see here for the full extensive list, you are enrolled as a member of the EAA on purchase of conference tickets), but all are welcome to join the conference.  It promises to be an interesting conference with the attendance of some of the most important archaeologists in Europe discussing a wide variety of topics, including a number of speakers discussing human osteology related topics.  Istanbul is also a fantastic place to host a conference positioned as it is between the crossing of the West into the East and vice versa, and boasting a city full of heritage, archaeology and art.

Is Gender Still Relevant? University of Bradford

The British Academy and the University of Bradford are holding a two day event on the question of whether gender is still relevant.  The mini conference runs from Wednesday the 17th to the Thursday the 18th of September and it is free to attend.  Guest speakers include Professor Rosemary Joyce from the University of California and Dr Roberta Gilchrist from the University of Reading, who will discussing sex and gender dichotomies in archaeology.  You can find out more information here and, as far as I am aware, there is still time to submit abstracts for the conference.

No doubt there will be more archaeology and osteology based conferences going on so please feel free to leave a comment below.

Bone Benefits of 3D Printing

Recently there has been some extraordinarily interesting articles in the press on the value of 3D printing in surgical procedures.  In particular the United Kingdom seems to be leading the way in producing and using 3D printed implants for use in reconstructive surgeries, as recent articles in the BBC, the Daily Telegraph and The Independent publications highlight.

Mr Craig Gerrand, a consultant orthopaedic surgeon in an NHS hospital in Newcastle-Upon-Tyne, England, recently announced the success of producing and fitting half of a 3D printed titanium hip into an unnamed patient who was suffering from chondrosarcoma.  Chondrosarcoma is a cancer of the cartilage cells and typically tends to affect the axial skeleton.  In this case the unnamed patient suffered severe damage to one half of his hip due to the effect of the destructive cancer.  In an effort to stop the spread of the cancer, which rarely responds to radiotherapy or chemotherapy, the surgeon was forced to remove half of the patient’s hip (termed an hemipelvectomy, which can be external or internal dependent on if the leg is to be amputated as well).

Before this, however, Mr Gerrand was able to construct and print a 3D titanium half model of the patient’s  hip which, along with the added attachment of a hip socket replacement, he was then able to implant into the patient following the removal of the chondrosarcoma affected bone.  The fake hip was based on scans and x-rays of the patient’s own hip for anatomical reasons and was fully produced using a 3D printer.  The printer used lasers to fuse together titanium powder, which slowly built up a model of the hip layer by layer.  The fake hip was then coated in a mineral into which the remaining bone in the patient’s healthy hip could fuse with, providing long-term stability during recovery and mobility.  Although the news articles on the case were only recently produced, the actual surgery itself was carried out over 3 years ago.  Wonderfully the patient continues to manage to walk with mobility aids, something that would be unthinkable if the surgeon had not been able to print and implant the titanium hip.

In other news recently, as reported by the BBC, the Welsh victim of a vicious motorcycle accident was able to benefit from the 3D printing of custom parts for use in maxillofacial reconstruction.  The use of 3D printing was used at each stage of the procedure, including the planning of the surgery and the reconstruction itself, by using titanium parts to stabilise or replace parts of the patient’s own facial bones.

Following the motorcycle accident, which severely damaged both of the patient’s zygomatic bones as well as sustaining damage to the maxilla, frontal and nasal bones, the patient’s face was reconstructed in a series of operations.  To achieve the aim of improving the patient’s face to almost pre-accident standards the surgeons scanned the skull of the individual using a CT scanner and printed the results using a 3D printer, the results of which helped to produce a symmetrical model of his skull to help plan the surgery in detail.  By using cutting guides and by being able to measure the facial skeletal anatomy directly, they managed to print titanium plates to match the symmetry of the patient’s face originally, and likely minimised the time the patient spent under anesthetic.  In the article the patient, from the city of Cardiff in Wales, movingly states how he now looks as he did before the motorcycle accident, adding that he was able to go out in public once again following the reconstructive surgery.

A model example of how the surgeons helped plan the surgery to improve the motorcycle accident man’s face with 3D printed titanium implants. The image shows the left zygomatic arch with the titanium implants in white against the model of the cranium. (Image credit: The BBC 2014).

The two innovative procedures above are fine examples of the value of integrating the latest technology into the operating theatre, but they also highlight some themes of the body and surgical intervention that interest me.  The benefits of being able to 3D print specific and specially made parts offer a ‘continuation’ for the patient of their own bodies, even with the distinct disconnect (and often intrusive procedures) between the effect of the trauma or disease process and the reconstructive attempts at re-structuring the body, as highlighted in the above orthopaedic cases.

3D printing is a fast-moving technology in the medical world, where even the possibility of being able to bioprint human organs and tissue is fast becoming a possibility for the future.  Perhaps most significantly it offers the option for the patient to use their own bodies (or, more specifically, their cells) to help cultivate a ‘second chance’ organ or tissue in the lab using artificial scaffolds to grow the tissue needed.  To a small degree this has already been carried out with certain tissues, but further work is needed to be able to bioprint human organs properly.  But back to the use of 3D printing in orthopaedic surgery.

Reconstructive orthopaedic surgery generally aims to improve the quality of life for the individual through physical manipulation and internal or external fixation of an implant onto, or into, the bone directly.  The benefits of this are not just anatomical but often also psychological, perhaps more so in maxillofacial procedures.  The patient may feel that their appearance has improved dramatically, or that they have been made to look more normal.  This can increase the positive social perception of the patient themselves and boost self-confidence.  Of course there are always risks associated with reconstructive orthopaedic surgery, the first and foremost being the fact that more damage may occur as a result of the often intrusive procedures, particularly the risk of implant fatigue and possibility of macro/micro fracture of surrounding bone material.

Internal and external fixations also often run the risk of infection, more so when there is the risk of repeated surgical interventions.  Internal fixation (such as intramedullary rodding) has the possibility of deep bone infection, whilst external fixation (such as the use of the Ilizarov frame) often results in small localised infections.  Nevertheless the risk of infection by implant is often controlled for by using clean surgical rooms, sterilised medical equipment and the infusion of antibiotics during and post-surgery.  Further to this, antibiotic laden cement is also often used during the surgical fixation of an implant as an added protector against infection through the introduction of foreign bodies.

I am also interested in the after effects of surgery in the perception of the self.  Titanium implant parts are typically manufactured for general use, although there is a dizzying variety of screws, plates and rods available to the orthopaedic surgeon.   Of course they are also shaped and made to fit the patient to a certain degree.  Titanium is a fairly hefty metal, with the patient often being able to tell that something heavy has been implanted into the body upon awakening from surgery.  It also often hammered or screwed into the bone, sometimes causing the bone to fracture or microfracture during the process, or afterwards as the patient starts to weightbear.  (As a side note orthopaedic surgeons are often built like rugby players because of the demanding physical aspect of orthopaedic surgery).

The new generation of 3D printed parts are often made of different materials than purely consisting of titanium.  Importantly there is the option to help improve the post surgical integration of existing bone and ceramic implants (such as hip replacements, which often use ceramic femoral heads) through the ability to print intricate designs to help meld with bone, and the ability to seed the ceramic scaffolds with the patients own cultured cells to promote  healthy bone growth (Seitz et al. 2005).  This is purely speculation and conjecture, but I wonder if the newer materials used, are of a much lighter material than titanium and are, as a result, less intrusive to the person undergoing the surgery?

What the 3D printing of implants offer is the opportunity to make identical and specifically made models of the  patient for their own use (Fedorovich et al. 2011), by either basing the custom build on an existing bone of the patient or by specifically making a part to improve what has either been lost to a disease process or a traumatic incident, to name the two main causes for orthopaedic reconstructive surgery.  There are also opportunities to help promote wound healing and prevent infection during and post-surgery (Lee et al. 2012), a step that is needed considering the rise of drug resistant germs, the general decline in pharmaceutical companies producing new antibiotics, and the widespread misuse of antibiotics in general (Mayo Clinic release).  3D printing then, I believe, is an important step in advancing and improving the techniques, approaches and materials used in orthopaedic surgery.

Learn More

• Watch Ben Garrod’s Secrets of Bones BBC TV series to learn more about just how wonderful the skeleton is.  Learn more about the remarkable 3D print of his skull here.

• Kristina Killgrove, over at Powered by Osteons, has a series of posts on her attempts to integrate 3D printing with teaching human osteology, check it out here.

• The frankly amazing news of the Netherlands surgeons who were able to produce a 3D model of a patient’s cranium which was then successfully implanted can be found here, although there has been a lack of evidence for this procedure in other mainstream or medical publications.

Bibliography

Fedorovich, N. E., Alblas, J., Hennink, W. E., Oner, F. C. & Dhert, W. J. A. 2011. Organ Printing: The Future of Bone Regeneration? Trends in Biotechnology. 29 (12): 601-606.

Lee, J-H., Gu, Y. Wang, H. & Lee, W. Y. 2012. Microfluidic 3D Bone Tissue model for High-Throughput Evaluation of Wound-Healing and Infection-Preventing Biomaterials. Biomaterials. 33 (4): 999-1006.

Seitz, H., Rieder, W., Irsen, S., Leukers, B. & Tille, C. 2005. Three-Dimensional Printing of Porous Ceramic Scaffolds for Bone Tissue Engineering. Journal of Biomedical Materials Research Part B: Applied Biomaterials. 74B (2): 782-788.

Skeletal Series 11: The Human Foot

The human foot is as distinctive and as complex as the human hand (D’Août et al.  2010).  The foot, or Pes, forms the distal terminus of the leg.  It helps to perform the two basic important functions of shock absorption and propulsion during bipedal locomotion, both of which require a high degree of stability.  The foot bones are the serial homologs of the hand bones an each foot individually is comprised of 26  individual skeletal elements as opposed to the hand’s 27  individual skeletal elements, indicative of the differing evolutionary roles of both limbs with the digits undergoing reduction and modification in mammals (White & Folkens 2005: 225).

As White & Folkens (2005: 292) note, the ‘human foot has changed dramatically during its evolution from a grasping organ to a structure adapted to bipedal locomotion’, where ‘mobility, flexibility and grasping ability has been lost’.  As humans are bipedal walkers the feet must take the full weight of the body during locomotion and this is reflected in hard and soft tissue anatomy (D’Août et al. 2008, D’Août et al. 2010, Gosling et al. 2008, Jarmey 2003).  The diagram below demonstrates the robust and compact nature of the pes elements.

The human foot, highlighting the articulated individual skeletal elements in dorsal and lateral view. Note the arch of the foot, the size of the calcaneus and general robusticity of the bones in comparison to the hand bones (Image credit: WebMD 2013).

Excavation

The excavation of the human skeleton should, where possible, be conducted with patience and great care for the recovery of all skeletal material possible (Brothwell 1981).  The elements that make up the foot, a total of 26 individual bones altogether (see below), are sturdy and largely compact bones, although it is likely that there will not be complete recovery of the distal phalanges due to their smaller size.  In supine and crouched burials the foot bones are likely to survive, although care must be taken when excavating at an unknown burial depth (Larsen 1997).  In cremation remains of individuals from archaeological sites it is still possible for certain elements to be recognised and described, especially in the case of the compact tarsal bones (Mays 1999).  In crowded burial grounds where the body is laid out in a supine position (lying flat on the back), as n the photograph below, burials often intersect each other, cutting off the lower part of the legs (Mays 1999).  This is a common feature in crowded burial grounds, and care must be taken when excavating and assigning individual skeletal elements to specific individual skeleton’s (Brothwell 1981).

A photograph of a Medieval burial ground near Brodsworth, Yorkshire, UK, from the 2007 excavation. Note the orientation and sequential laying of supine burials, and how the lower portion of the legs have been covered or destroyed by other burials. Courtesy of the University of Hull and the Brodsworth project.

Basic Musculature and Skeletal Anatomy

There are 26 bones in the human foot which are grouped into 7 tarsals, 5 metatarsals and 14 phalanges, for a total of 33 joints, of which 20 are actively articulated (See image below for skeletal elements in articulation, and Gosling et al. 2008, Mays 1999, White & Folkens 2005, for further reference).  The main joints of the foot itself include the transverse tarsal joint and tarsometatarsal joint (see figure below).  The talocrural (ankle) joint, the articulation between the leg and the foot, forms an important part of the stability of the foot, one of the main differences behind the pes and the manus (the wrist is extremely movable and flexible in comparison to the ankle).  Unlike the hand the foot cannot grasp and is not capable of fine motor movement, however the adipose tissue and plantar fascia (or aponeurosis) is tightly packed underneath the heel (calcaneus bone) for shock absorption during locomotion (Gosling et al. 2008: 304).  The stability of the ankle joint is strengthened by the wedge shaped articulation of the talus and calcaneus bones and by the strong collateral ligaments helping to tightly pack the anatomy during movement (Gosling et al. 2008: 304-305).

The individual sections and bones of a right sided human foot, which includes the tarsals, metatarsals, and phalanges from proximal to distal (Image credit: Encyclopedia Britannia 2007).

It is important to note here the two main arches of the human foot, the transverse arches and the medial and lateral longitudinal arches.  The functional anatomy of the arches allows the foot to remain stable during the pressures and energy exertion of locomotion but also retain flexibility so that it can grip different surfaces whilst enhancing forward propulsion (Gosing et al. 2008: 309).  The transverse arch is located along the cuneiforms, the cuboid bone and all of the metatarsal bases, and simply forms a domed shaped which strengthens the foot during locomotion.  The medial longitudinal arch is the highest of the arches and runs along the instep of the foot, alongside the calcaneus, talus, navicular, and cuneiform bones and up to the first three metatarsals (Gosling et al. 2008: 309).  The lateral longitudinal arch is lower and flatter than the media arch and runs alongside the calcaneus, the cuboid, and the fourth and fifth metatarsals (Gosling et al. 2008: 2010).

The arches are supported in their skeletal frame by a complex arrangement of extrinsic and intrinsic muscles, ligaments and tendons.  The sole of the foot contains numerous intrinsic muscles which mimic the muscles found in the hand, which include digitorum (flexor/abductor) and lumbrical muscles, whilst the plantar view houses the inter-osseus planar muscles (Gosling et al. 2008: 284).  It is worth remembering that the majority of the larger muscles that articulate and move the foot are located in the leg itself (soleus, gastrocnemius, and the anterior/posterior tibial muscles).  Although I will not discuss the soft tissues further, I highly recommend the ‘Human Anatomy Colour Atlas and Textbook’ by Gosling et al. (2008) as a key reference source.  The book has a high number of quality dissection photographs and anatomical diagrams clearly highlighting the different muscle, ligament and tendon structures.

Skeletal Elements: Tarsals

The 7 tarsal bones of the foot help to form the longitudinal and transverse arches of the foot, which is often called the tarsus.  The talus articulates superiorly with the distal tibia and fibula, the calcaneus forms the heel of the foot and supports the talus (White & Folkens 2005: 291).  The navicular sites between the 3 cuneiforms and the head of the talus (White & Folkens 2005: 292).  The 3 cuneiforms and the cuboid act as a second row of tarsal bones and articulate with the proximal heads of the 5 metatarsals.

Dorsal view of the tarsal elements and proximal metatarsals (Image credit: University of Cincinnati).

The Talus

The talus (astragalus in animals) is the 2nd largest tarsal and sits atop of the calcaneus, between the tibia and the fibula.  It is distinct in it’s saddle shape, with a head (that sides medially when viewed from above) and a body that forms the posterior portion of the bone.

The Calcaneus

The largest tarsal, forming the heel bone, the calcaneus is located inferior of the talus and supports the distal portion of the foot.  An intact calcaneus is extremely distinct, and can be sided by placing the ‘heel’ away from you and the articular surfaces superiorly, and the shelf (sustentaculum tali) should point the side it is from.

The Cuboid

The cuboid is located on the lateral side of the foot, between the calcaneus and the 4th and 5th metatarsals.  It is distinct in appearance because of its large size with a cuboidal body.  There is no articular surface on the lateral side of the bone, and the inferior surface has a pronounced cuboid tuberosity.

The Naviculuar

The navicular sits snugly between the talus and the cuneiform elements, and has a distinct concave proximal surface.  A tubercle points medially when viewed from the view of the talus.  It is similar in shape to the scaphoid carpal.

The Cuneiforms:

Medial

The medial cuneiform is the largest of the three cuneiforms, sitting between the navicular and base of the first metatarsal.  It is less of a wedge shape than the other two cuneiforms, and distinguished by it’s ‘kidney-shaped facet for the base of the first metatarsal’ (White & Folkens 2005: 298).

Intermediate

This cuneiform is the smallest of the cuneiforms and is located between navicular and the 2nd metatarsal base.  It articulates on either side with the lateral and medial cuneiforms.  The non-articular dorsal surface is key for siding, with a projecting surface points towards the side it comes from when the concave facet is pointed away from the holder (White & Folkens 2005: 298).

Lateral

Located at the centre of the foot, and intermediate in size between the intermediate and medial cuneiform, the lateral cuneiform sits at the base of the foot.  It articulates distally with the 2nd, 3rd and fourth metatarsal bases, proximally with the navicular, medially with the intermediate cuneiform and laterally the cuboid (White & Folkens 2005: 299).

Metatarsals

The 5 rays of the metatarsals are typically labelled as MT 1-5, with MT1 representing the hallux, or the big toe (as the thumb is named the pollex).  The metatarsals are all ‘tubular bones with rounded distal articular facets (heads) and more squarish proximal ends (bases)’ (White & Folkens 2005: 300).  They are more easily sided by the morphology of their bases.  It is important to note that each of the tarsals in the distal row (either of the 3 cuneiforms or the cuboid above) articulates with one or more of the metatarsal bases (White & Folkens 2005: 300).  The first metatarsal is the most massive and squat, whilst all non hallucial metatarsals articulate with each other.  The fifth metatarsal bears a distinctive blunt styloid process on it’s lateral side that makes it fairly identifiable.

A basic dorsal view of the metatarsal and phalangeal bones in the right foot. Note that the hallux (first digit medially) has only a proximal and a distal phalanx whilst the other digits have a proximal, intermediate and distal phalanx (Source).

Phalanges

The foot phalanges are the same in design as the hand phalanges with heads, bases and shafts but are much shorter and squatter than the hand phalanges.  Again they come  in three rows, with 5 proximal phalanges, 4 intermediate phalanges and 5 distal phalanges;  it should be noted that the MT1 hallux has, as does the thumb (pollex), only the proximal and distal phalanges with no intermediate phalanx, and is remarkably more chunkier then either of the other four rays.

Each Proximal Phalanx displays a ‘single, concave proximal facet for the metatarsal head and a spool-shaped surface distally’ (White & Folkens 2005: 306).

Each Intermediate Phalanx displays a ‘double proximal articular facet for the head of the proximal phalanx’, and again have a trochlea shaped distal articular facet (White & Folkens 2005: 306).

Each Distal Phalanx displays a double articular proximal facet for the head of the intermediate phalanx and a terminal tip of the bone, resulting in a non-articular pad (White & Folkens 2005: 307).

These phalanges are all much shorter than their companions in the hand, with the foot phalanges having a more circular shaft cross section compared to the D shape  shaft of the hand phalanges.  Foot phalanges generally display a more constrictive shaft than hand phalanges, although it can be difficult to side them and it is best done with a full replica or whole specimens for comparative analysis (White & Folkens 2005: 308).  

Further Online Sources

• A detailed map of each element and the surrounding musculature (as well as relaxing classical music!) can be found on the website of the UMFT Department of Anatomy and Embryology site.  Be aware there are detailed anatomical prosection and dissection diagrams, but it is a free, fascinating and wonderful source (and with the music especially relaxing!).
• A number of websites have detailed diagrams and photographs of the foot from a medial/lateral and a dorsal/planar view, including this site and this one.
• Finally, do you know your tarsal bones? Test yourself here!

Bibliography

Brothwell, D. R. 1981. Digging Up Bones: The Excavation, Treatment and Study of Human Skeletal Remains.  Ithica: Cornell University Press.

D’Août, K., Pataky T.C., De Clercq, D. & Aerts, P. 2009. The Effects of Habitual Footwear Use: Foot Shape and Function in Native Barefoot Walkers. Footwear Science. 1 (2): 81. doi:10.1080/19424280903386411 

D’Août, K., Meert, L., Van Gheluwe, B., De Clercq, D. & Aerts, P. 2010. Experimentally Generated Footprints in Sand: Analysis and Consequences for the Interpretation of Fossil and Forensic Footprints. American Journal of Physical Anthropology. 141: 515–525. doi: 10.1002/ajpa.21169

Gosling, J. A., Harris, P. F., Humpherson, J. R., Whitmore I., & Willan P. L. T. 2008. Human Anatomy Color Atlas and Text Book. Philadelphia: Mosby Elsevier.

Jarmey, C. 2003. The Concise Book of Muscles. Chichester: Lotus Publishing. 

Jurmain, R. Kilgore, L. & Trevathan, W.  2011. Essentials of Physical Anthropology International Edition. London: Wadworth.

Larsen, C. 1997. Bioarchaeology: Interpreting Behaviour From The Human Skeleton. Cambridge: Cambridge University Press.

Marsland, D. & Kapoor, S. 2008. Rheumatology and Orthopaedics. London: Mosby Elsevier.

Mays, S. 1999. The Archaeology of Human Bones. Glasgow: Bell & Bain Ltd.

White, T. & Folkens, P. 2005. The Human Bone Manual. London: Elsevier Academic Press.

Grave Matters: Archaeology & Politics

Archaeology and politics are often uncomfortable bedfellows, perhaps more so than many archaeologists like to admit.  This, it is fair to say, is especially the case when dealing with the issue of human remains in either prehistoric or historical instances.  However archaeological sites are never ‘static’ shots of one particular time, but rather often act as an accumulation of an extended period of time, compacted into the earth for the archaeologist to decipher.  They neither belong fully to the past, nor fully to the present.  Further to this we (the archaeologists) don’t just view and interpret an archaeological site from a historical (or prehistorical) vantage point, we necessarily (and often subconsciously) filter the evidence present through our own life experiences, professional knowledge and socio-cultural factors.  Whilst this post could go off on a theoretical tangent here, I will keep it cogent to this point alone: human bodily and skeletal remains are an emotive subject, especially when archaeology and politics mix.  So bearing this in mind, here are several examples where politics meets the trowels edge, often resulting in friction between the two.

The Spitalfields cemetery (possible one of the largest excavated in the world with just under 11,000 burials excavated) will long be remembered in the human osteological circles of Britain as an exceptional excavation.  It is site of such osteoarchaeological and social historical wealth that it has to be one of the most documented cemetery excavations carried out in Britain, if not the world for its richness of remains and evidence for the social context that the individuals inhabited (Pethen 2010).  A report on the archaeological and historical background of the area can be read here, detailing the wealth of Roman, Medieval and Early Modern archaeological finds and cemetery sites (Elders et al. 2010).  The Spitalfields area itself is a site of beauty, a breath of fresh air in a crowded city, with the beautiful baroque Christ Church dominating the area near its centre.

In a letter in the recent edition of Private Eye (Issue 1345)  a reader has wrote of the proposed school extension of the Christ Church primary school onto the Spitalfields graveyard.  This is due to a severe over-crowding of the school in an area where local council authorities have been banned from opening new state schools, unless they are to be built as an academy.  Academies are another feature of the unpopular UK Secretary of State for Education Michael Gove’s educational reforms, which operate from central government funds and dictate their own curriculum, although they (and Gove’s other reform ideas) have come under sustained attack from numerous teaching unions and local authorities for distorting choice, spoiling funds and promoting the teaching of creationism.  A campaign to stop the school development can be found here, but I would caution that the school may have little choice in the matter.

A section of the Medieval cemetery excavated at St Mary Spital burial ground highlighting the closeness of the buried individuals. In particular note the overlaying of the bodies, highlighting the fact that they had not been buried in coffins. This is not the Spitalfields site but reminiscent of similar burial traditions within medieval London (Source: Current Archaeology 2012).

Meanwhile in Zimbabwe, in southern Africa, the ruling party Zanu-PF have likely won again following recent 2013 elections (1).  The incumbent president, Robert Mugabe, has remained in power following 30 years of rule despite continued disputed election results in recent years and statistically dubious polls, with a large number of deceased individuals being named as voters on the recent polling lists.  Zanu-PF have often used underhand methods to maintain power before in the country, which is still currently edging out of a deep recession which had seen currency hyperinflation, including voter intimidation, forced removal and sustained campaigns of violence.  Yet in 2008 a power brokerage deal was agreed with the opposition party, the MDC, led by Morgan Tsvangirai, who has joined the government as Zimbabwe’s prime minister.

Grisly news articles broke in early 2011 when it was reported that over 600 human bodies (possibly thousands) in various states of decay had been found in various mine shafts at Chimbondo, near Mount Darwin, in northern Zimbabwe.  A large portion of the bodies found have been removed from context and buried elsewhere, but others remain in-situ.  Claims abound from sources inside Zimbabwe that they represent victims of the colonial period (from Zimbabwe’s War of Independence), whilst other governments and opposition parties have questioned whether they are instead the victims of Zanu-PF’s sustained campaigns of intimidation and violence.  Various news reports have suggested that the bodies have been known about for a number of years, and that individuals still had bodily fluids or soft flesh attached, or leaking from, their bodies.  Amnesty International have called for forensic experts to have access to the mass graves to carry out detailed forensic investigative tests to assess the demography of the mass graves, age and sex the bodies and positively ID individuals, by carrying out DNA studies, if possible (Jurmain et al. 2011: 22).

Yet despite repeated calls for access from Amnesty International and other organisations and governments from around the world, none is forthcoming or has been granted from the Zanu-PF led government of Zimbabwe (Amnesty International 2011).  The victims remain potent symbols of political propaganda, whilst their individual identities themselves are being disregarded.  By refusing to identify individuals and profile the dead, the authorities in Zimbabwe are helping to undermine the individuals themselves and the families who have lost loved ones, regardless of whether they died in the independence war or as a result of the discord and violence post-independence.  This makes the political parties implicit with guilt.

Unidentified individuals found in the 2011 mass graves in northern Zimbabwe. The conditions of the clothes and of the bodies, from this site and others, indicate the possibility that the victims were killed post-War of Independence. (Source: Daily Mail 2011).

In Florida, in the USA, there has been recent upset and outrage over the refusal (still as of early August 2013) for permission to be granted to a team of forensic anthropologists from the University of South Florida to excavate and help identify suspected abuse victims from a 1930’s onwards reform school in Mariana, northern Florida.  This is despite the results of ground penetrating radar surveys conducted on a suspected cemetery site at the Mariana campus of the Dozier School For Boys, which reportedly found evidence for 50 suspected graves, a far larger percentage then previously thought or suspected (Hennig 2012).  Rick Scott, the current Florida Governor, has disagreed with the forensic anthropologists over the exhumation of the graves, citing that the University team do not have the legal requirements to excavate the remains.  This has been met with outrage from families and survivors of the reform school, with one predominant group nicknamed the White House Boys who urgently want answers on how many people died at the school through abuse.  Outrage has also been picked up on a larger scale across the US, with Senator Bill Nelson decrying the ridiculous stance the state of Florida has taken on the issue.

The US has fairly tough laws on the excavation of human remains, be they historical or prehistoric, with tough guidelines and stringent checks enforced through the NAGPRA (Native American Graves Protection and Repatriation Act) laws.  However, even allowing for the complexities of US legal requirements for the exhumation of human remains, the reform school investigation and associated problems in excavating possible abuse victims seems especially convoluted, with state departments blaming each other for the confusion.  Rick Scott does has form for his distaste for all things anthropological, stating that anthropology is not needed in Florida.  Somewhat of an oversight when the state is home to many important archaeological sites and osteological collections (Windover, for instance).  News is to follow as to whether Rick Scott will give in to the families and researchers demands to let the forensic anthropologists to exhume the remains, with a vote set for Tuesday (13th August 2013) (2) (3) (4) (5).  Since the original writing of this post the decision was taken for anthropologists to investigate and exhume the bodies.  This continues currently, and has fruitfully positively identified a number of the young individuals who were tortured and buried at the location of the reform school.  Graves have also been found outside of the regular cemetery, suggesting that ad-hoc burials took place.

The Doziers school for Boys were the abuse was alleged to have taken place. (Source: Daily Mail 2012).

Upon reading this entry you may think that politics and archaeology are at best awkward partners paired up only when necessary, but the great thing about archaeology and anthropology is that they implicitly depend on inter-disciplinary research projects across national borders, continents and cultures.  There are success stories of how well archaeology has been implemented in national and political guidelines (the UK for instance has a strict and often well observed set of heritage and archaeological guidelines for developers) but, for this post at least, it is necessary to highlight how government obstructions and human remains are often used as political weapons in modern contexts.

(1) 04/08/13 update: Latest news reveal Mugabe and Zanu-PF have indeed won the election.

(2) 07/08/13 update: According to the Tampa Bay Times, the Florida Cabinet has agreed to let USF researchers exhume the individuals at the Dozier reform school.  This will mean that living families and relatives of individuals who died at the school could finally get some answers and evidence on individuals who were buried at the school.  Excavations will start later this month.

(3) 01/09/13 update: The Guardian and other news sources have reported the first details of the excavation at the Dozier reform school, with finds already including funerary artefacts such as coffin fittings and human skeletal material.

(4) 07/08/14 update: Positive identification of some of the victims of the Dozier reform school in Florida has now been announced.  Strange Remains has an update detailing the use of DNA from victims families in the positive identification of skeletons that have been excavated from clandestine burials dating to the 1940’s.  Distressingly there may be further burials located within the Dozier reform school grounds.

(5) 04/10/14 update: The positive identification of two further victims of the Dozier reform school, in the panhandle of Florida, have been announced.  Strange Remains has an update on the identification of two of the boys found in graves at school by anthropologists at the University of South Florida, highlighting the abuse and neglect that was unchecked at the reform school.

(6) 01/012/15 updated: I have mistakenly referred to the incorrect burial ground for Spitalfields, please see the informed comments from CH below.  The post will be updated shortly to reflect the correct London post-medieval burial ground discussed.

Bibliography:

Amnesty International. 2011. Zimbabwe: Mass Graves Must Be Exhumed by Forensic Experts. Amnesty International Press Release.

Elders, J. et al. 2010. Archaeology and Burial Vaults: Guidance Notes for Churches. Council for British Archaeology: York.

Hennig, K. 2012. Searching For Answers. University of Southern Florida: Tampa.

Jurmain, R. Kilgore, L. & Trevathan, W.  2011. Essentials of Physical Anthropology International Edition. London: Wadworth.

Pethen, H. 2010. Christchurch Spitalfields CE Primary School, Commercial Street, London E1: Historic Environment Assessment. Museum of London Archaeology: London.

Andreas Vesalius’s ‘De Humani Corporis Fabrica’

I still remember seeing the vivid woodcuts of the human body looming out of the school history textbook for the first time, as clear as the sunlight that entered that dark room.  The course title was ‘Medicine through Time’, a fascinating ramble through man’s attempts at healing the body that started at the Upper Palaeolithic and ended at the beginning of the NHS and modern medicine.

The figures that loomed out were of course from Andreas Vesalius’s (1514-1564) anatomical book, ‘De Humani Corporis Fabrica Libre Septem‘ (1543), an illustrated manual of the human body in 7 books.  Produced at a time of great learning, during the flourishing of the Renaissance, the books depicted the human body in vivid anatomical detail.  Remarkably Vesalius published the first edition of the book at the age of 30, taking great pains to present the illustrations as accurately as possible.  By using woodcuts throughout the text, with the odd use of intaglio (engraved copper plates), Vesalius cultivated great artists to help detail his anatomical and dissection findings.  He had the text printed by Joannis Oporini  in Basel, Switzerland, who was a printer of foremost talent in 16th century Europe.

But where did Vesalius, as a anatomist and dissector, fit into anatomical history?  Vesalius was born in Brussels, Belgium (then the Hapsburg Netherlands), in 1514 to a family of physicians and, under the directions of Jacques Dubois and Jean Fernel, studied anatomy and the theories of Galen at the University of Paris in 1533.  He was forced to move his anatomical studies to Leuven, Netherlands, at the outbreak of war between the Holy Roman Empire and France in 1536,  However he shortly moved to Padua, Italy, to complete his doctorate and took up the chair of surgery and anatomy after its completion.  It is during this time that he conducted dissections on cadavers as a regular part of his student lessons as a primary learning tool, and promoted the use of directly observed descriptions during the dissections.

This was a challenge to the established orthodoxy of Galen‘s (AD 126- 200) anatomical legacy.  Galen studied the Hippocratic theory of pathology, and heavily promoted the theory of the 4 bodily humors and the idea of human temperaments.  In particular Galen advanced the knowledge of human anatomy in many areas, including describing muscle tones and the functions of agonists and antagonists in the musculo-skeletal system, alongside major progressions in the understanding of circulatory, respiratory and nervous systems.  Although Galen’s medical corpus was accepted as largely fact, his anatomical dissections were carried out on Barbary apes and pigs, as Imperial Rome in the 2nd century AD prohibited human cadaver dissection.

One of the ‘muscle men’, displaying the superficial anatomy of the major muscles in the anterior view of the human body (Source: University of Glasgow).

This led to several major inaccuracies in the work of Galen and in the understanding of the biology of the human body, and it wasn’t until Vesalius that certain views were corrected and amalgamated into Galen’s legacy.  This included a number of corrections from Galen’s original works, such as recognising that the human jawbone (mandible) is one bone and not two, that women do not lack a rib compared to males (taken from the biblical idea), and that the interventricular septum of the heart is not porous as Galen advocated, alongside a plethora of other insights.

This largely occurred because Vesalius advocated active learning during dissection of human cadavers (themselves often executed prisoners).  Importantly it should be noted that Vesalius work built upon work throughout the intervening centuries, particularly in the view of contemporary Renaissance artists and anatomists.  His was not the first body of work focusing on the intricacies of the human body during this period, but it was one of the most detailed and finely executed, leading it to become an instant classic in his own lifetime.  Although he improved Galen’s theory of circulation, it wasn’t until the English doctor William Harvey (1578-1657) accurately described the systematic circulation and properties of blood (1628).

The University of Toronto has recently acquired a previously unknown and privately held 2nd edition copy of ‘De Human Corporis Fabrica’, and it is making the book accessible for researchers to study the text itself at the Thomas Fisher Rare Book Library.  Remarkably the unknown edition includes annotations likely made by Vesalius himself, notes where he has corrected the printed text or made notes regarding what to include in the next printed edition of the book, which unfortunately was never printed.  This typifies the character and nature of Vesalius as a dissector and researcher, but it also helps highlight the nature of science itself, how through the investigation of previous studies can inform future work and rectify mistakes or misunderstandings.  In particular is also raises the subject and value of comparative anatomy between species, of homology, of the similarities and differences between mammals.

Perhaps gruesomely, a human skin bound edition of the book survives and currently resides at Brown University.  The practice of human skin binding is known as ‘Anthropodermic Bibliopegy’ and, as Wikipedia points out, dates back till at least the 17th century.

Dental Delights and Disability in Archaeology

I’ve recently had the joy of a dealing with a dental abscess affecting the left hand side of my mandible, and whilst I’m thankful for modern medicine I can only imagine the pain and frustration for pre-modern populations suffering with such an infection, especially those who didn’t have access to antibiotics and strong painkillers.  As such I haven’t posted properly for a while, and it might be a bit longer before I do.  Having had surgery to relieve the effect of the swelling and to drain the infection and remove two pesky teeth (with added complications courtesy of Fibrous Dysplasia), I’m once again learning how to chew (farewell 1st and 3rd left mandibular molars!).  It has also given me the time to think about the role of disability in the archaeological record and how it is approached by modern-day researchers.  What follows below is a very quick and brief overview of the main points of how disability has been approached in the archaeological sector and the changes therein.  Articles of interest are noted in the bibliography.

Dettwyler famously wrote a paper entitled Can paleopathology provide evidence for compassion (1991: 375-384, PDF embedded) that rightly questioned the interpretations of archaeologists and osteologists on the inferred aspects of care and compassion that disabled individuals from the archaeological record may or may not have received during their lifetimes.  The author cautioned that archaeologists and researchers are not ‘justified in drawing conclusions either about quality of life for disabled individuals in the past or attitudes of the rest of the community from skeletal impairment of physical impairment’ (Dettwyler 1991: 375).  This was a much-needed wake up call, and rightly raised questions in the realms of archaeology and palaopathology regarding how we viewed individuals, and how we analysed them.

The majority of disability studies before the Dettwyler (1991) article focused on disabled individuals as case studies, reported in journals and rarely integrated or investigated as part of the society or cemetery population they may belonged to.  Mays (2012) rightly investigated the impact of the relative value of individual case studies compared to quantitative and problem orientated population studies, and found that although the publishing gap had lessened between the two types, singular case studies still predominated.  Mays (2012) main contention is that individual case studies do little to further the advance of palaeopathology, something which Larsen (1997) effectively demonstrates throughout his book and review (2002), in the consideration of how palaeopathology can indicate society or cultural wide rituals, actions or lifestyles.

Since the publication of the Dettwyler paper there has been a slew of articles, journals and books dedicated to researching disability as evidenced from the skeletal and archaeological record, both from a bioarchaeological perspective and from a theory perspective (Battles 2011, Brothwell 2010, Hawkey 1998, Kleinman 1972, Vilos 2011, Wood et al. 1992).  Indeed the study of disability and the implications for affected individuals, their communities and societies, has moved on considerably since the descriptive days of Calvin Wells, especially in the consideration of the theory of ‘compassion’ as an evolutionary force in the primate family (Hublin 2009, Stewart et al. 2012), or as evidenced in other mammals (Fashing & Nyuyen 2011).

This is in accordance with the rise and debate of disability theory and studies in numerous other disciplines.  This has had real life applications in many areas of modern-day life, where multi-agented approaches to understanding,  recognising and implementing programs that are designed to raise awareness or life quality for disabled individuals.  Two prominent examples from the UK are the 2005 Disability Discrimination Act and the 2010 Equality Law where disability itself is given a legal definition, and here we come to a prominent problem in the archaeological and palaeopathological record itself.

Disability, as we would recognise it today, can mean both a physical and/or a mental impairment that can be substantial and lifelong, and it is worth noting some problems inherent in the archaeological record.  Firstly, in the archaeological record, we can only recognise physical disability when it has affected the skeletal remains of individuals, normally at a late and severe stage in the disease progression (Aufderheide & Rodriquez 1998, Waldron 2009, Wood et al. 1992).  As such, a large number of individuals with diseases or traumatic injuries that only affected the flesh will go unknown, and as such are unstudied.  Secondly, there is no universal or standard definition of disability that archaeologists and researchers use, it is solely up to the person/persons to define clearly and openly which definition they are using at the outset of their research (and there are a lot of definitions and models depending on which source you base your definition on).  Thirdly, the usage of terminology itself, such as the very word disability, can have vastly different connotations or implications for different populations and cultures (Battles 2011).

There may have been distinct differences as to who was considered disabled or not in historic and prehistoric cultures, and we should, as researchers, always be aware of observer bias ourselves (Dettwyler 1991).  As such researchers should always be clear who they are addressing, and the possible differences highlighted, where evidence is available, as to how a disabled person was treated within their culture when archaeological or cultural evidence is available.

To complicate the matter further is the osteological paradox‘, as highlighted by Larsen (1997), Woods et al. (1992) and Wright & Yoder (2003) amongst others, which heavily influences the health status of skeletal remains that survive and that are then studied.  Therefore it should always be understood that no skeletal sample is entirely representative of their population, that there are many caveats (Hahn 1995, Roberts 2000).

Battles (2011) highlighted the need to move towards a more holistic approach to disability, to take advantage of different fields (including physical anthropology, sociocultural anthropology, experimental studies and archaeology itself) to understand disability at archaeological sites and affected individuals, to a model that integrates the data and insight of the various fields.  In particular Battles (2011) makes the salient point of noting the individuals  (largely females and sub-adults) that historically have been under-studied in archaeological and population analyses.

An important methodological update has been the advancement of a ‘Bioarchaeology of Care‘, as espoused by Tilley & Oxenham (2011), where a four stage assessment of an individual produces an assessment of the care needed for the disabled individual found in a Neolithic Vietnam community.  The stages are: (1) describing,  diagnosing and documenting the individual and site, (2) identify the clinical/functional impacts of disease or trauma, and determine if care was needed, (3) produce a model of care, and finally (4) interpret the implications for the individual and society, as well as possible indications for the identity and nature of both (Tilly & Oxenham 2011: 36).  It could be argued that other researchers have espoused the same sentiments (Roberts & Manchester 2010, Vilos 2011), but it is the clear initiation of the applying the model to individuals who fit the criteria that will hopefully produce further studies and elicit meaningful result which highlight this recent study as one to watch.  The Tilley & Oxenham (2011) model is particularly useful for prehistoric cases where there are no written or documentary sources.

Hawkey’s (1998) study of musculoskeletal markers (MSM’s) of a disabled individual from a New Mexico Pueblo culture highlighted the worth of applying existing osteological techniques to disabled individuals in order to assess the quality of bodily movement.  The modelling of the movement capable for this individual suggested that bodily manipulation, feeding, and the cleaning of this person was likely carried out by members of his culture (possibly family relatives, although this is conjecture) due to the severity of his disability (Hawkey 1998: 330).  Craig & Craig (2011) make extensive use of modern medical imaging to diagnosis a specific disease (fibrous dysplasia) in the case of a sub-adult from an English Anglo-Saxon site.  The striking bone expansion in the mandible is discussed within the social sphere of the community that the individual belonged.  The implications, via the the inference of position of the body within the grave, grave goods and grave location, and studies into Anglo-Saxon culture and social stratification give rise to the theory that the individual was not treated any differently due to his disability, although it is unknown if the disease led to the early demise of the individual (Craig & Craig 2011: 3).

Craig & Craig’s (2011) case study, and the above studies, highlight the use of modern medical literature and imaging technology in establishing a likely disease diagnosis, yet Brothwell (2010) rightly highlights the dangers of the differential diagnosis of diseases in skeletal remains at a macroscopic level.  Waldron’s (2009) palaeopathology handbook presents an ideal source on how to identify diseases that can lead to disability, but highlights the value of the differential diagnosis when the osteologist cannot be exactly sure of the disease.

The battery of scientific techniques used in archaeological investigations, including aDNA analysis, trace chemical analysis, and isotopic analysis amongst others, have become significantly refined within the past two decades, and are now allowing for a more nuanced understanding of individual and population dynamics (Brown & Brown 2011).  This includes the ability to analysis the movement of a person in a landscape within their lifetime (Marstellar et al. 2011), and to understand the changes in diet and the effects of diet on the body (Larsen 1997, Roberts 2000, Roberts & Manchester 2010). It also includes the ability to indicate the likely exposure of populations to various chemicals and diseases (Barnes et al. 2011), and exploration of how social structure (Bentley et al. 2012), and hence the role of the population or of the individual, changed through time.

Perhaps what the above studies cannot show, especially in prehistoric societies, are the actions of the disabled individuals themselves.  It is most likely that we will never know if they took an active interest in their society, if they took part, or how they felt as disabled individuals, or even if they saw themselves as disabled (Battles 2011, Hahn 1995).  Compassion  itself cannot be excavated (Dettwyler 1991), but with careful examination of the available evidence results can be produced that suggest that severely disabled individuals did survive past natural limitations.

The progress continually being made in the hard sciences and in the humanities continues to advance our knowledge of past populations via their skeletal remains and their cultural context.  The understanding of disability within an archaeological and osteological context provides the opportunity to investigate of how individual’s survived, and whether care was a key component (Hawkey 1998, Kleinman 1978, Tilley & Oxenham 2011).  This is a burgeoning area of bioarchological research, and when combined with a multidisciplinary approach, it opens up a wide range of interesting and diverse approaches and avenues.

Case Studies, Theories and Further Information:

Full articles are linked where possible, although a number hide behind Journal pay walls.

Aufderheide, A. C. & Roderiquez-Martin, C. 1998. The Cambridge Encyclopedia of Human Palaeopathology. Cambridge: Cambridge University Press.

Barnes, I., Duda, A., Pybus, O. G. & Thomas, M. G. 2011. Ancient Urbanization Predicts Genetic Resistance to Tuberculosis. Evolution. 65 (3): 842-848.

Battles, H. 2011. Toward Engagement: Exploring the Prospects for an Integrated Anthropology of Disability. Explorations in Anthropology. 11 (1): 107-124.

Bentley, R. A., Bickle, P., Fibiger, L., Nowell, G. M., Dale C. W., Hedges, R. E. M., Hamiliton,. J., Wahl, J., Francken, M., Grupe, G., Lenneis, E., Teschler-Nicola, M., Arbogast, R-M., Hofmann, D. & Whittle, A. 2012. Community Differentiation and Kinship Among Europe’s First Farmers. Proceedings of the National Academy of Sciences Early Edition. 1-5. (Early View).

Brothwell, D. 2010. On problems of Differential Diagnosis in Palaeopathology, as Illustrated by a Case from Prehistoric Indiana. International Journal of Osteoarchaeology. 20: 621-622.

Brown, T. & Brown, K. 2011. Biomolecular Archaeology: An Introduction. Chichester: Blackwell Publishing.

Churchill, S. E., Franciscus. R. G., McKean-Peraza, H. A., Daniel, J, A. & Warren, B. R. 2009. Shanidar 3 Neandertal Rib Puncture Wound and Palaeolithic Weaponry. Journal of Human Evolution. 57: 163-178.

Craig, E. & Craig, G. 2011. The Diagnosis and Context of a Facial Deformity from an Anglo-Saxon Cemetery at Spofforth, North Yorkshire. International Journal of Osteoarchaeology. (Early View doi: 10.1002/oa.1288).

Dettwyler, K. A. 1991. Can Palaeopathology Provide Evidence for “Compassion”? American Journal of Physical Anthropology. 84: 375-384.

Fashing, P. J. & Nguyen, N. 2011. Behaviour Towards the Dying, Diseased, or Disabled Among Animal and its Relevance to Palaeopathology.  International Journal of Palaeopathology. 1: 128-129. 

Hahn, R. A. 1995. Sickness and Healing: An Anthropological Perspective. New Haven: Yale University.

Hawkey, D. E. 1998. Disability, Compassion and the Skeletal Record: Using Musculoskeletal Stress Markers (MSM) to Construct an Osteobiography from Early New Mexico. International Journal of Osteoarchaeology. 8: 326-340.

Hublin, J. J. 2009. The Prehistory of Compassion. Proceedings of the National Academy of Sciences. 106 (16): 6429-6430.

Kleinman A. 1978. Concepts and a Model for the Compassion of Medical Systems as Cultural Systems. Soc Sci Med. 12: 85-93.

Knusel, C. J. 1999.  Orthopaedic Disability: Some Hard Evidence. Archaeological Review Cambridge. 15: 31-53.

Larsen, C. 1997. Bioarchaeology: Interpreting Behaviour from the Human Skeleton. Cambridge: Cambridge University Press.

Larsen, C. S. 2002. Bioarchaeology: The Lives and Lifestyles of Past Peoples. Journal of Archaeological Research. 10 (2): 119-166.

Marstellar, S. J., Torres-Rouff, C. & Knudson, K. J. 2011. Pre-Columbian Andean Sickness Ideology and the Social Experience of Leishmaniasis: A Contextualised Analysis of Bioarchaeological and Palaeopathological Data from San Pedro de Atacama, Chile. International Journal of Palaeopathology. 1 (1): 23-34.

Mays, S. 2012. The Impact of Case Reports Relative to Other Types of Publication in Palaeopathology. International Journal of Osteoarchaeology. 22: 81-85.

Roberts, C. A. 2000. ‘Did They Take Sugar? The Use of Skeletal Evidence in the Study of Disability in Past Populations’. In Hubert, J. (ed) Madness, Disability and Social Exclusion: The Archaeology and Anthropology of Difference. London: Routledge. 46-59.

Roberts, C. & Manchester, K. 2010. The Archaeology of Disease. Stroud: The History Press.

Stewart, F.A., Piel, A.K., O’Malley, R.C., 2012. Responses of Chimpanzees to a Recently Dead Community Member at Gombe National Park, Tanzania. American Journal of Primatology. 74: 1–7.

Tilley, L. & Oxenham, M. F. 2011. Survival Against the Odds: Modelling the Social Implications of Care Provision to the Seriously Disabled. International Journal of Palaeopathology. 1 (1): 35-42.

Vilos, J. D. 2011.  Bioarchaeology of Compassion: Exploring Extreme Cases of Pathology in a Bronze Age Skeletal Population from Tell Abraq, U. A. E. Master’s Dissertation. Las Vegas: University of Nevada.

Waldron, T. 2009. Palaeopathology. Cambridge: Cambridge University Press.

Wood, J. W., Milner, G.R., Harpending H. C., & Weiss, K. M. 1992.  The Osteological Paradox: Problems of Inferring Prehistoric Health from Skeletal Samples.  Current Anthropology 33:  343-370.

Wright, L. E. & Yoder, C. J. 2003.  Recent Progress in Bioarchaeology: Approaches to the Osteological Paradox. Journal of Archaeological Research 11 (1): 43-70. (**An extensive bibliography of articles can be found in the bibliography of this article**).

The Origins of Tuberculosis & Smallpox

The following articles cited were brought to my attention by the good work of Confusedious: A Science Blog, and his entries on TB and its  possible origin.

Surprising Origins of Tuberculosis & Smallpox

Recent genetic investigations into the origin of the above diseases, of the chromosomes in TB and the study of smallpox’s ‘biological clock’, has revealed interesting information regarding their origin.   TB and Smallpox were previously thought caused or at least had its early origins during the domestication of animals, and by the dense urbanisation of human populations, first seen during the Mesolithic to Neolithic transition (Tuberculosis- Barnes et al 2011, Larsen 1997, Roberts & Manchester 2010, Smith et al 2009, Smallpox- Li et al 2007, Waldron 2009).

Compression Of Vertebrae As An Effect Of TB

Tuberculosis was originally thought to be spread from bovine at the period of domestication, with the strains M. Tuberculosis and M. Bovis to be considered the main organisms for TB infection in humans.  New genetic research has led to distinguish that M. Tuberculosis did not evolve from M. Bovis at the time of domestication of animals as a direct zoonosis; however it must be remembered that ‘it is probable that a necessary condition for its transference from animal to human is the close association between the two’ (Roberts & Manchester 2010: 184, Smith et al 2009).  I’d imagine the intensification of the Neolithic domestication undoubtedly led to higher rates of cross-species infection.  Research has also shown that the Mycobacterial Tuberculosis strain appeared some 15,300-20,400 years ago, well before the domestication of the earliest animals (Roberts & Manchester 2010: 185).  However there is no doubting the record that during the Neolithic, and up to the present day, that TB has damaged numerous lives.  The effects of TB on the human body can produce results found in osteological remains (Waldron 2009).  This will be discussed in a later blog entry on diseases found in human bones.

The threat of smallpox, a unique infectious disease to humans, was wiped out in AD 1980, but its origins are mysterious.  As Roberts & Manchester (2010: 181) note smallpox (Variola major or minor) ‘would obviously need highly populated urban areas for its success…and it is unlikely it was a problem until urbanization occurred’.  Recent genetic investigations into the origin of the Variola major/minor have discovered that it likely diverged from an ancestral African rodent-borne Variola-like virus either 68,000 to 16,000 BP (Li et al 2007).  However, it is well known that in its most virulent form in humans as smallpox, it has ravaged human urbanised populations for at least 2000 years, and is definitely dated to 10,000 BP.  Curiously, from documentary data and archaeological data, it seems there is a particular lacking of recorded smallpox cases in ancient Greece and ancient Rome (Roberts & Manchester 2010).

The Effects of Smallpox Decimated The Americas When The Europeans Helped Spread the Disease in the 16th Century, As Depicted In This, The Florentine Codex.

New genetic data is providing the backdrop for how infectious diseases spread, and more about their origin.  It is also helping scientists develop past population pathways for infection routes and rates (Jurmain et al 2011).It is apparent that new genetic data has opened up a whole raft of new research potentials into the origins and evolution of tuberculosis, and the relationship before, during and after the domestication of animals.

Bibliography:

Barnes, I.Duda, A. Pybus, O. G. Thomas, M. G. 2011. ‘Ancient Urbanization Predicts Genetic Resistance To Tuberculosis’. In Evolution. 65 (3): 842-848. Blackwell Publishing: London.

Jurmain, R. Kilgore, L. & Trevathan, W.  2011. Essentials of Physical Anthropology International Edition. London: Wadworth.

Li, Y. Carroll, D. S. Gardner, S. N. Walsh, M C. Vitalis, E. A. & Damon, I. K. 2007. ‘On The Origin of Smallpox: Correlating Variola Phylogenics with Historical Smallpox Record’. In PNAS. 104 (40). October 2^nd.  15,787-15,792.National Academy of Sciences: Wisconsin.

Roberts, C. & Manchester, K. 2010. The Archaeology of Disease Third Edition. The History Press: Stroud.

Smith, N. H. Hewinson, R. G. Kremer, K. Brosch, R. & Gordon, S. V. 2009. ‘Myths and Misconceptions: The Origin and Evolution of Mycobacterium tuberculosis’. In Nature Reviews: Microbiology. Vol 7. 537-544. Macmilan Publishers Limited: London.

Waldron, T. 2009. Palaeopathology: Cambridge Manuals in Archaeology. Cambridge:Cambridge University Press.

Skeletal Series Part 7: The Human Arm

In this post we shall focus on the main bones located in the arm.  They are the Humerus, Radius & Ulna.  The previous post on the shoulder elements (Scapula & Clavicle) can be found here.  It should be noted that the bones discussed  in this post, known as the forelimb, are the homologs to the bones in the leg, the hind limb.

Articulation of arm with the distal humerus and proximal radius and ulna making the elbow joint (Image credit: Wikipedia 2011).

Excavation

As noted in previous Skeletal Series posts care should be taken with excavating human remains, and the maxim that ‘context is everything’ should be well noted with detailed plans of the in-situ remains made.  It is likely that some damage will have occurred to the smaller ulna and radius as they are more fragile then the larger and denser humerus bone.  A record of the condition of the bones should be made, alongside what contextual information is available (Mays 1999, White & Folkens 2005).

Arm Anatomy & Function

The humerus articulates proximally with the scapula and clavicle, as discussed in the last entry (See diagram below).  The distal humerus articulates with the proximal radius and ulna head.  This articulation makes up the elbow, which will be discussed in detail below.  At the distal end of the radius and ulna the carpals are located, which make up the wrist.  These, alongside the other elements in the hand, will be discussed in the next Skeletal Series post.

The individual brachium and antebrachium skeletal elements and major skeletal landmarks, as seen in articulation with the full limb (image credit: Wikipedia 2011).

The function of the forelimb is to provide a rigid limb to help hold, grab and move surfaces and objects.  The shoulder girdle and arm bones have moved away from our evolutionary history of weight-bearing limbs, and have become essential in helping humans to manipulate and move objects with astounding dexterity (Jurmain et al 2011).

Elbow Joint

The elbow joint (image credit: CK-12).

This joint in particular is important to understand as it is a key hinge joint.  The diagram below helps to mark out the distal humerus with the proximal radius and ulna in articulation.  The elbow is one of the strongest points of the body in terms of bone hitting strength.  The two main movements of the elbow are flexion and extension of the humerus and ulna, alongside the pronation of the radius and ulna in turning the arm over (White & Folkens 2005).  The joint itself has a large synovial membrane that protects the articulation points of the bone, whilst the main muscles involved are the Brachialis & Brachiaoradialus (at the anterior side) and the Triceps Brachii & Aconaeus towards the posterior side.  The lateral and medial muscles are the Supinator and Extensor muscles, alongside the Flexor muscles and Flexor Carpi Ulnaris muscles (White & Folkens 2005, but also here).

Anterior elbow joint in articulation, highlighting the major skeletal landmarks of the three bones that make up the joint. Image credit: here.

The Humerus

The humerus is the largest bone in the upper body, and ‘compromises of a proximal end with a round articular head, a shaft, an irregular distal end’ (White & Folkens 2005: 203).  It articulates with the Glenoid cavity (or fossa) of the scapula, and as mentioned, the proximal radius and ulna at the distal end.  The humerus head faces medially, whilst the surgical (or anatomical) neck is the groove that encircles the head for the attachment of the joint capsule (White & Folkens: 203-4).  Both the Greater and Lesser Tubercle are muscle attachment eminences that help move and rotate the upper arm.  On the Greater tubercle (the more posterior and large of the tubercles) rugosities for the insertion of the rotator cuff muscles are round, which help in rotation and adduction and abduction of the arm (White & Folkens 2005).

Main skeletal landmarks of the humerus (click to enlarge). Image credit: Google 2011.

The Shaft of the humerus is variably triangular in section, going from more cylindrical at its proximal end to more triangular in shape towards the distal end (Larsen 1997).  The Deltoid tuberosity is an important feature located on the lateral side of the shaft.  It is the insertion site of the deltoideus muscle, and is recognised by its roughened appearance.  Towards the distal end of the humerus we have several key features that are easily identifiable in recognising this as an upper limb element.

The Olecrannon Fossa is the largest of three hollows located posteriorly at the distal end, and accommodates the olecrannon process of the ulna during forearm extension.  The Capitulum is the rounded eminence that forms the lateral portion of the distal humeral surface, and it articulates with the head of the radius (White & Folkens 2005: 211).  The Lateral and Medial Epicondyle are the non articulating projections of bone, the medial is more prominent than the lateral epicondyle.

The humerus is relatively easy to recognise by the certain features picked out above, but parts can be confused with the tibia and femur.  With the femur, the head has a distinct depression called the Fovea Capitis whilst the humerus lacks this feature (Mays 1999).  The humeral shaft is smaller and less triangular than the tibial shaft.  When siding remember that the olecrannon fossa is posterior and the medial epicondyle is larger, and the humeral head faces medially.  The deltoid tuberosity is found laterally (White & Folkens 2005: 214).

The Ulna

The Ulna is the longest and thinnest bone of the forearm, and articulates proximally with trochlea of the humerus and head of the radius.  Distally, it articulates with the ulnar notch of the radius and an articular disk that separates it from the carpals.  The Olecrannon of the ulna is located on the most proximal part of the ulna; it is the insertion point for triceps brachii muscle.  The Trochlea Notch articulates with the trochlea articular surface of the humerus.  The Coronoid Process is the ‘anterior beak shaped projection at the base of the semilunar notch’ (White & Fokens 2005: 219).  The Radial Notch  is the small articular surface for the radius, and is located along the lateral side of the coronoid process.  The Radial Articulation (Ulna Head)  is the distal, lateral round articulation that conforms to the ulna notch on the radius.  The distal and proximal ends of the ulna are fairly distinctive and indicative of the element, however as White & Folkens (2005) and May (1999) point out, the shafts could be mistaken for radial or fibular shafts.

The ulna and the radius and their associated skeletal landmarks, click to enlarge. Image credit: Wikipedia 2011.

The Radius

The radius is a relatively small bone and shortest of the three in the forelimb.  Its name was gained for the action it goes through as the ‘turning movement about the capitulum of the humerus’ (White & Folkens 2005: 214).  At the proximal end it articulates with the humerus and medially with the ulna on both proximal and distal ends, whilst also distally it articulates with two carpal bones of the wrist.

The Head is a round articular structure at the proximal end of the radius, and as stated above articulates with both the humerus and ulna.  The Neck is a slender segment between the head and the radial tuberosity.  The Radial Tuberosity is a blunt rugged structure on the anteromedial site of the proximal radius that marks the insertion for the biceps brachii muscle (Mays 1999).  The  Styloid Process is a sharp projection located on the lateral side of the distal radius whilst the Ulnar Notch is a concave articular hollow on the medial corner of the distal radius.

Discussion: Wrist Fracture

Colle’s fracture is a break at the distal end of the radius and ulna that results in a ‘dinner fork deformity‘ with dorsal angulation, and displacement of the fracture with radial angulation.  The counterpart to this is Smith’s fracture which is the same but the fracture is displaced in the opposite direction, ie palmar (Marsland & Kapoor 2008: 96).

Smiths fracture highlighting the displacement of the distal radius. Image credit: Wikipedia 2011.

These type of fractures often occur because of trips or falls onto outstretched hands, as an automatic safety device by the body.  In modern contexts they also happen in a variety of sport environments.  These types of breaks are often easy to treat with splints and plaster casts, although they sometimes require surgery to correct the breaks and/or angles.  The patients can often be left with a visible deformity, but likely without any pain whatsoever (Marsland & Kapoor 2008: 96).  In archaeological examples these type of fractures can be found in any number of contexts or cultures.  It is important to note that, as Larsen (1997) says, many human cultures’ skeletal series often exhibit these breaks, and it can shed light into pathways of differing lifestyles.  Larsen also notes that whilst there is a large osteological literature on injuries in comparison to more population based studies which would help to highlight inferences on accidents and conflict in both historic and prehistoric societies (1997: 109).

Further Information

• A detailed diagram of the upper arm muscles can be found here and of the lower arm here.
• A helpful page for muscle names and motions can be found here.
• Further information on Colles’ Fractures can be found here.

Bibliography

Jurmain, R. Kilgore, L. & Trevathan, W.  2011. Essentials of Physical Anthropology International Edition. London: Wadworth.

Larsen, C. 1997. Bioarchaeology: Interpreting Behaviour From The Human Skeleton. Cambridge: Cambridge University Press.

Marsland, D. & Kapoor, S. 2008. Rheumatology and Orthopaedics. London: Mosby Elsevier.

Mays, S. 1999. The Archaeology of Human Bones. Glasgow: Bell & Bain Ltd.

Roberts, C. & Manchester, K. 2010. The Archaeology of Disease Third Edition. Stroud: The History Press.

Waldron, T. 2009. Palaeopathology: Cambridge Manuals in Archaeology. Cambridge: Cambridge University Press.

White, T. & Folkens, P. 2005. The Human Bone Manual. London: Elsevier Academic Press.