Tiptoeing through the rest of his life: A functional adaptation to a legshortened by femoral neck fracture

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  • Salvage excavation of a Roman cemetery (1st–2nd century CE) at the site of ancient Erculam (region ofCampania), Italy, yielded the skeleton of an older male with a healed fracture of the femoral neck thatreduced the femoral neck angle and resulted in leg shortening. The right foot shows bony alterations thatappear to have developed as a consequence. The distal joint surfaces of the first and second metatarsalsextend dorsally for articulation of the proximal phalanges in hyper-dorsiflexion. I argue that, in orderto compensate for the shortened leg, the man lengthened it functionally by bearing weight primarilyon his toes when he walked, rather than striking the heel first and then pushing off from the toe. Theseverity of degenerative joint disease in the right knee and in the metatarsophalangeal joints suggeststhat the injury occurred years before the man’s death. This case adds to the bioarchaeological record ofindividuals who adapted to impaired mobility in the past, and it may be of interest to scholars who studythe bioarchaeology of impairment and disability.

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    Attribution-NonCommercial-NoDerivatives 4.0 International