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Earliest surgical amputation?

September 21, 2022

In 2020, archaeologists in Borneo uncovered a fossilized human skeleton 31,000 years old. Given modern archaeology, there is nothing surprising about such old remains. Nor that the left foot was missing, since old skeletons often are partial.

But closer inspection showed that the left foot wasn’t merely missing. It had been removed while the individual was a child, allowing regrowth of the tibia and fibula ends in the years since. It’s easy, of course, to imagine all the many ways a child might lose a foot. The authors considered them:

The trauma pattern observed is not consistent with clinical descriptions of non-surgical amputation, except in cases of modern trauma in which a large metal blade or a mechanical process has been involved. Non-surgical amputations, commonly as a result of accidents, do not cause clean oblique sectioning and are not clinically recorded to sever the lower limb of both the tibia and fibula, as is the case for TB1. Blunt-force trauma from an accident or an animal attack typically causes comminuted and crushing fractures, features that are absent from the clearly simple and oblique amputation margin of TB1. Amputation as punishment is considered unlikely, particularly given the careful treatment of the individual in life after the amputation and in burial, which is not consistent with someone considered deviant. Completely remodelled lamellar bone has enclosed the inferior margin of the fibula (Fig. 3e,f), indicating that TB1 died a minimum of 6–9 years after the initial trauma—confirming that this was not a fatal pathology. There is no evidence of infection in the left limb, the most common complication of an open wound without antimicrobial treatment. The lack of infection further rules out the probability of animal attack, such as a crocodile bite, because an attack has a very high probability of complications from infection owing to microorganisms from the animal’s teeth entering the wound.

Well, it still is a stretch to think surgeons were amputating limbs at that time. That conclusion remains a matter of elimination of other causes due to their probable effects. As easy example, infection and how quickly an individual clears it always is a roll of the dice. So I’ll remain skeptical of that claim, barring other discoveries that buttress it. I’m not saying it’s wrong. The far past is another world — actually, a series of worlds — that we see only dimly through clues it has left here and there.

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