Humerus varus deformity in Roman period burials from Kellis 2, Dakhleh, Egypt

Abstract

Humerus varus deformity (HVD) occurs unilaterally in a female (#85) skeleton and bilaterally in a male (#124) from Kellis 2, a Roman period cemetery (circa 300-450 AD) from Dakhleh, Egypt. The affected humeri were shortened, their glenohumeral joints deformed, and their upper diaphyses were angulated. The skeletons were otherwise normal. The severity of the changes suggests that the underlying growth disturbances occurred early in postnatal development. The differential diagnosis considers the mucopolysaccharidoses, thalassemia, infection, and birth trauma, with the latter being favored. Clinical data show limited morbidity or functional impairment in individuals with HVD, although radiographic analysis suggests that #85 may have favored her dominant arm. Ortner and Putschar (1981), and Hershkovitz et al (1991) describe the only other archaeological cases of HVD. These authors provide useful, though limited, information on the differential diagnosis of HVD in archaeological specimens. Future research should focus on documenting the prevalence and expressivity of HVD in Mediterranean population samples where thalassemia evolved. HVD is relatively common in thalassemics and this approach would be valuable for documenting the range of osseous responses characteristic of HVD.

Reconstructing infant weaning histories at Roman period Kellis, Egypt using stable isotope analysis of dentition

“…The bioarchaeological component of the DOP consists of ongoing research concerning mortuary treatment, paleodemography and migration, ancient diet and nutrition, skeletal growth and development, changes in health and disease, and paleogenetics (Birrell, 1999;Dupras, 1999;Fairgrieve and Molto, 2000;Molto, 2000Molto, , 2001Molto, , 2002Graver et al, 2001;Parr, 2002;Tocheri and Molto, 2002;Maggiano et al, 2003;Stewart et al, 2003;Williams and Dupras, 2004;Tocheri et al, 2005). At present, the majority of this research is focused on the past inhabitants of the Roman period town of Kellis (Fig.…”

Humerus Varus in a Subadult Skeleton from the Medieval Graveyard of La Madeleine (Orléans, France)

“…Although coxa vara is a well recognised deformity, the structural analogue involving the proximal humerus is rarely discussed in either paleopathological (Molto, ) or medical literature (Ogden et al , ). Moreover, clinical reports of humerus varus mainly focus on corrective surgical procedures.…”

“…Clinical data indicate that individuals suffering from humerus varus can have a slight impairment of shoulder motion, usually expressed as a mild to moderate limitation of glenohumeral abduction (Lucas & Gill, ; Ellefsen et al , ). In his study of an Egyptian female skeleton showing varus deformity of her left humerus, Molto () interprets radiographic bone resorption on the deltoid region as evidence that she used this arm less than her normal right arm. In the present case, X‐rays do not show any cortical bone modification.…”

“…In clinics also, humerus varus in children may be more common than is thought, as the condition is often discovered during adolescence when length discrepancy becomes obvious (Ogden et al , ). Moreover, in the study of dry bones within an archaeological context, diagnosis can be made difficult by the unfused status of the epiphysis (Molto, ). Fragmentation of bones and partial preservation of skeletons can also make it impossible to detect humerus varus and/or to precise its etiology.…”

“…Several cases of humerus varus deformity have been reported in paleopathological literature (Ortner & Putschar, ; Merbs & Vestergaard, ; Capasso, ; Hershkovitz et al , ; Anderson, ; Molto, ). However, all concern adult or adolescent individuals.…”