Normal and pathological foot bones variability in historical and modern series

Abstract

Introduction: This thesis was devoted to the study of the foot, mainly in ancient collections. The foot is a forgotten bone set in many anthropological, paleopathological, and forensic studies. However, being the key structure that maintains the upright position, it is basic to know the life of a specific individual and the destiny of a population. To understand the structural and biomechanical changes of the modern foot, it is necessary to appeal to Paleoanthropology; the unique science that studies in detail the foot anatomy of our ancestors. Thus, through an interdisciplinary study, this analysis meets a series of scientific needs regarding foot morphology and the changes in its structure between populations. Aim: We analyzed the normal and pathological variability of the foot bones, emphasizing mainly on factors that alter its structure. Moreover, we considered the particular features of each collection and their anatomical changes across time. Materials and methods: To carry out our study, we used 890 samples that correspond to pairs of skeletonized feet of contemporary and ancient osteological collections from Spain, Italy, and Oman with different dating. We applied morphological and metric methods to check their differences, with different purposes. In addition, we used exploratory exams such as CT scans or RX cinematography in living patients. Results: Six studies summarized all our results between 2016 to 2019. They are classified according to the etiology of the osteological changes in the foot. In regard to normal variability, we proposed equations to discriminate sex through metrical methods in the navicular bone. In addition, we observed the cuboid facet of the navicular bone, described as an occasional finding and present in the 52.7% of contemporary individuals in Spain, without significant differences between sexes and series. Taking into consideration the pathological variability, the most significant differences between the Spanish and Italian series were in the X-XIX centuries CE, with degenerative processes being the most common variables. On the other hand, we also proposed a new methodology to estimate non-pathological flat foot in dry bones; found new frequencies of bipartition of cuneiform bones exceeding the world average and, reported the oldest case of the Mueller-Weiss disease in the ancient Egypt. 12 Discussion: Considering the lack of bibliography in most of the studied topics, we proposed a series of new equations and methodologies to be applied in the laboratory. In addition, we suggested new focuses about foot morphology, which will be useful for setting biological profiles and aiding in population studies. Our results are the expression of osteological modifications, present since many centuries ago up to current day. Some factors could explain these changes. Footwear, diseases, genetics, or occupational stress are the most common. Nonetheless, despite technology being very present in the studies of many diseases that affect the feet, there is still much work to do.