Traumatic bowing deformities in tubular bones

Stuart-Macadam, Patricia; Glencross, Bonnie; Kricun, Morrie E.

doi:10.1002/(sici)1099-1212(199807/08)8:4<252::aid-oa425>3.0.co;2-z

Cited by 25 publications

(11 citation statements)

References 27 publications

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“…Traumatic bowing deformities, such as acute plastic bowing deformities (APBD), in which deformation occurs without complete fracture, may also cause deformation of long bones. In a review of the subject by Stuart-Macadam et al (1998), it was found that most cases of APBD occurred in children and that the forearm was the most frequently affected site. The condition is rare and deformities may be resolved during normal growth and development.…”

Section: Discussionmentioning

confidence: 99%

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Evaluation and interpretation of residual rickets deformities in adults

Brickley

Mays

Ives

2008

Intl J of Osteoarchaeology

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Recent research has considerably improved the recognition and recording of rickets and osteomalacia in archaeological human bone, but the recognition and recording of residual deformities of rickets present in adults is still limited. The aim of this study was to assist with differential diagnosis of residual rickets deformities and determine which of the deformities that are characteristic of rickets could be identified in the adult skeleton. Long bone deformities were investigated, with research focusing on deformities of the leg bones. One hundred and thirty-five adults from the historic cemetery of St Martin's, Birmingham, where vitamin D deficiency was known to have been widespread, were analysed. Deformities of leg bones were three times as frequent as arm bone deformities, and deformity of both the femur and tibia was the most frequently recorded combination of leg bones. Medial bending of the tibiae and anterior bending of femora, both at the proximal end, were the most frequently recorded types of deformities. A review of a range of conditions that can cause bowing deformities, and comparison of bowing recorded in children with rickets and the present cases, concluded that the most likely cause of the deformities recorded was residual changes linked to rickets. In this community, bowing deformities linked to rickets were quite common amongst adults and probably did not have adverse social consequences, but further studies are required to determine whether this attitude to deformity was more widespread.

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Section: Discussionmentioning

confidence: 99%

“…The condition is rare and deformities may be resolved during normal growth and development. The study by Stuart-Macadam et al (1998) found that a very small number of cases of APBD occurred in adults, where the fibula was the most frequently affected bone. In adults, industrial accidents were the most common cause.…”

Section: Discussionmentioning

confidence: 99%

Evaluation and interpretation of residual rickets deformities in adults

Brickley

Mays

Ives

2008

Intl J of Osteoarchaeology

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“…In the broadest sense, bowing resulting from mechanical forces is due to trauma, i.e., a trauma to a degree lower than breaking stress (Angle, 1954; Swischuk and John, 1995; Stuart‐Macadam et al, 1998), which brings in another possible etiology.…”

Section: Differential Diagnosismentioning

confidence: 99%

Double child burial from sunghir (Russia): Pathology and inferences for upper paleolithic funerary practices

Formicola

Бужилова

2003

American J Phys Anthropol

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The double child burial from Sunghir (Russia) is a spectacular Mid Upper Palaeolithic funerary example dated to about 24,000 BP. A boy (Sunghir 2) and a girl (Sunghir 3), about 12-13 and 9-10 years old, respectively, were buried at the same time, head to head, covered by red ocher and ornamented with extraordinarily rich grave goods. Examination of the two skeletons reveals that the Sunghir 3 femora are short and exhibit marked antero-posterior bowing. The two femora do not show any asymmetry in the degree of shortening and bowing. Bowing affects the whole diaphysis and shows a regularly incurved profile, with the highest point at midshaft. Pathology is confined to the femora, and no other part of this well-preserved specimen shows abnormality. The isolated nature of the Sunghir 3 anomalies points to cases reported in the medical literature under the label of "congenital bowing of long bones" (CBLB). These are a group of rare conditions exhibiting localized, sometimes bilateral, bowing and shortening which are nonspecific and may result from different causes, including abnormalities of the primary cartilaginous anlage (i.e., the aggregation of cells representing the first trace of an organ). Localized ossification disturbances, possibly linked to a diabetic maternal condition, might explain the shortening and the coincidence of maximum midshaft curvature with the position of the primary ossification center, as well as the lack of involvement of other skeletal parts. This scenario, rather than other possibilities (early bilateral midshaft fracture, acute plastic bowing deformities, or faulty fetal posture), provides the most likely explanation for the Sunghir 3 femoral deformities. The intriguing combination of a pathological condition apparent since birth with a spectacular burial of unusually positioned young individuals of different sexes recalls significant aspects of the triple burial from the contemporary site of Dolní Vestonice (Moravia), evoking a patterned relationship between physical abnormality and extraordinary Upper Paleolithic funerary behavior.

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“…Stress ranging between elastic and fracture limits causes bending that remains after stress is removed. Lower arm bones are the bones most frequently involved, typically a result from a fall onto an outstretched hand (Naga and Broadrick, 1977;Stuart-MacAdam et al, 1998). In many instances, the fracture of one of the lower arm bones is associated with APBD of the other bone (Borden, 1975;Crowe and Swischuck, 1977;Resnick et al, 1995;Price, 1996).…”

Section: Towards a Diagnosismentioning

confidence: 99%

The Upper Paleolithic triple burial of Dolní Věstonice: Pathology and funerary behavior

Formicola

Pontrandolfi

Svoboda

2001

American J Phys Anthropol

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This work focuses on paleopathological analysis of one of the skeletons from the Gravettian triple burial of Dolní Vestonice (Moravia) and addresses issues of Upper Paleolithic funerary behavior. The burial includes the well-preserved skeletons of three young individuals. The skeleton in the middle (DV 15) is pathological and very problematic to sex; the other two (DV 13 and DV 14) are males and lie in an unusual position. The young age, the possibility of a simultaneous interment, and the position of the three specimens have given rise to speculations about the symbolic significance of this spectacular and intriguing funerary pattern. The pathological condition of the skeleton in the middle further emphasizes its peculiarity. Main pathological changes of the DV 15 skeleton include: asymmetric shortening of the right femur and of left forearm bones, bowing of the right femur, right humerus, and left radius, elongation of fibulae, dysplasias of the vertebral column, and very marked enamel hypoplasias. Scrutiny of the medical literature suggests that the most likely etiology is chondrodysplasia calcificans punctata (CCP) complicated by trauma and early fractures of the upper limbs. CCP is a rare inherited disorder characterized by stippled ossification of the epiphyses. The cartilaginous stippling is a transient phenomenon that disappears during infancy, leaving permanent deformities on affected bones. Among the different forms of CCP, the X-linked dominant form is that resulting in asymmetric shortening and is lethal during early infancy in males. Thus, survival of DV 15 until young adult age would require the specimen to be a female. Clinical findings often associated with the disease (erythemas, ichthyosis, alopecia, cataracts, and joint contractures, among others) would emphasize the singular aspect of this individual, pointing to a condition that should be carefully taken into account when speculating on the significance of that peculiar burial.

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Traumatic bowing deformities in tubular bones

Cited by 25 publications

References 27 publications

Evaluation and interpretation of residual rickets deformities in adults

Evaluation and interpretation of residual rickets deformities in adults

Double child burial from sunghir (Russia): Pathology and inferences for upper paleolithic funerary practices

The Upper Paleolithic triple burial of Dolní Věstonice: Pathology and funerary behavior

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