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An Investigation of the Biomechanical Implications of Lower Limb Fractures and Leg Length Disparity

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Date Issued:
2016
Abstract/Description:
One of the primary goals of biological anthropology is to develop an accurate understanding of human anatomy, health, disease, and injury in both modern and archaeological populations. Paleopathological analyses are a fruitful means of identifying disease and injury in skeletal assemblages, but the individual long-term biomechanical effects associated with pathological conditions have not yet been adequately explored in the literature. Leg fractures are a common pathological condition in both modern and archaeological populations, the effects of which may alter the biomechanics of gait. A growing body of clinical literature demonstrates that abnormal ambulatory function may have far-reaching effects in the rest of the body.To assess the long-term consequences of pathological conditions of the lower extremities, the relationship between lower limb long bone fracture occurrence, incidence of leg length disparity (LLD), and temporomandibular dysfunction (TMD) was analyzed. A total of 56 adult individuals (29 fractured, 27 unfractured) from the Hamann-Todd Osteological Collection (HTOC) at the Cleveland Museum of Natural History (curated between 1912 and 1938) were examined in this study. In total, the sample consisted of 37 males and 19 females (ages 25-76) of either black or white ancestry. LLD was assessed by taking standardized measurements of the lower limb long bones. TMD was analyzed by scoring the presence and severity of osteoarthritis of the temporomandibular joint (TMJ OA), dental attrition, and antemortem tooth loss. Kendall's Tau correlation statistics were used to assess morphological integration between all unique pairwise combinations of lower limb and jaw measurements among unfractured and fractured groups. Results indicate that several measures of LLD and jaw dysfunction are correlated differently in the unfractured and fractured groups. Comparisons of the All Unfractured and All Fractured groups most often showed higher absolute correlation values in unfractured individuals. Samples were also subdivided and compared based on known sex. Significant differences in patterns of morphological integration were observed between male and female sub-samples. Significant correlation values were almost always higher in the unfractured sample than in the fractured sample. Females, however, demonstrated both significant increases and significant decreases in absolute correlation values when comparing fractured and unfractured samples. Thus, patterns of significant differences in morphological integration between the lower limbs and jaw differ for males and females, with fairly consistent decreases in integration strength in the former and a mixed pattern of integration strength increases and decreases in the latter, when a leg fracture is involved. It is argued that these differences are explained by fundamental sexually dimorphic morphological and kinematic differences between males and females, such that fractures resulting in LLD affect the two sexes differently. Gendered lifetime social experiences and activity patterns may also explain the different male and female patterns identified in the analysis. These insights are applied to larger anthropological questions of social identity and the long-term injury experience.
Title: An Investigation of the Biomechanical Implications of Lower Limb Fractures and Leg Length Disparity.
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Name(s): Mills, Elizabeth, Author
Dupras, Tosha, Committee Chair
Williams, Lana, Committee Member
Starbuck, John, Committee Member
University of Central Florida, Degree Grantor
Type of Resource: text
Date Issued: 2016
Publisher: University of Central Florida
Language(s): English
Abstract/Description: One of the primary goals of biological anthropology is to develop an accurate understanding of human anatomy, health, disease, and injury in both modern and archaeological populations. Paleopathological analyses are a fruitful means of identifying disease and injury in skeletal assemblages, but the individual long-term biomechanical effects associated with pathological conditions have not yet been adequately explored in the literature. Leg fractures are a common pathological condition in both modern and archaeological populations, the effects of which may alter the biomechanics of gait. A growing body of clinical literature demonstrates that abnormal ambulatory function may have far-reaching effects in the rest of the body.To assess the long-term consequences of pathological conditions of the lower extremities, the relationship between lower limb long bone fracture occurrence, incidence of leg length disparity (LLD), and temporomandibular dysfunction (TMD) was analyzed. A total of 56 adult individuals (29 fractured, 27 unfractured) from the Hamann-Todd Osteological Collection (HTOC) at the Cleveland Museum of Natural History (curated between 1912 and 1938) were examined in this study. In total, the sample consisted of 37 males and 19 females (ages 25-76) of either black or white ancestry. LLD was assessed by taking standardized measurements of the lower limb long bones. TMD was analyzed by scoring the presence and severity of osteoarthritis of the temporomandibular joint (TMJ OA), dental attrition, and antemortem tooth loss. Kendall's Tau correlation statistics were used to assess morphological integration between all unique pairwise combinations of lower limb and jaw measurements among unfractured and fractured groups. Results indicate that several measures of LLD and jaw dysfunction are correlated differently in the unfractured and fractured groups. Comparisons of the All Unfractured and All Fractured groups most often showed higher absolute correlation values in unfractured individuals. Samples were also subdivided and compared based on known sex. Significant differences in patterns of morphological integration were observed between male and female sub-samples. Significant correlation values were almost always higher in the unfractured sample than in the fractured sample. Females, however, demonstrated both significant increases and significant decreases in absolute correlation values when comparing fractured and unfractured samples. Thus, patterns of significant differences in morphological integration between the lower limbs and jaw differ for males and females, with fairly consistent decreases in integration strength in the former and a mixed pattern of integration strength increases and decreases in the latter, when a leg fracture is involved. It is argued that these differences are explained by fundamental sexually dimorphic morphological and kinematic differences between males and females, such that fractures resulting in LLD affect the two sexes differently. Gendered lifetime social experiences and activity patterns may also explain the different male and female patterns identified in the analysis. These insights are applied to larger anthropological questions of social identity and the long-term injury experience.
Identifier: CFE0006694 (IID), ucf:51917 (fedora)
Note(s): 2016-08-01
M.A.
Sciences, Anthropology
Masters
This record was generated from author submitted information.
Subject(s): leg fractures -- leg length disparity -- temporomandibular dysfunction -- social identity -- disability -- morphological integration
Persistent Link to This Record: http://purl.flvc.org/ucf/fd/CFE0006694
Restrictions on Access: public 2017-02-15
Host Institution: UCF

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