[From FerneIius’ Universa Medicina, Geneva, 1679.1

BOOKSHE.LF BROWSING STUDIES IN PALEOPATHOLOGY, XXVI

PLEISTOCENE LUXATIONS*

ROY L. MOODIE, PH.D.

SANTA MONICA, CALF.

INTRODUCTION AngeIes and went over a11 the materials

T HE purpose of this paper is to de- with me, and I have profited greatIy from

scribe accurateIy and interpret Iogi- his suggestions.

caIIy, the types of Iuxations seen in the Three types of arthritic disturbances are

skeIetons of the PIeistocene mammaIs from described in this paper. The first is that of

the Ranch0 Ia Brea. Some of the eIements Ioss of head of femur due to an infection in

showing partia1 Iuxation had been frac- the hip-joint. Second, the compIete Iux-

tured and one of these bones has been ation of traumatic origin, and third,

described in another connection and is partia1 Iuxations as described in the peIvis

noted further on. of the sabre-tooth and in a femur of the

A study of the reIation between the same anima1, as we11 as numerous exampIes

angIe of torsion of the femora of the giant in the woIf. One has to make an arbitrary

woIf and Iuxations has been considered choice from the woIf materia1 for there are

in this study to see if the twisting of the dozens of exampIes of arthritic disturb-

shaft can have had an influence on the antes grading out from partia1 Iuxations

degree of Iuxation. I shaI1 devote a section to very ‘Iight arthritides* of this essay to a consideration of the probIem of torsion.

MATERIALS

I have been engaged in this study during I have had entire access to the unrivaIIed severa years, and have discussed the coIIections of PIeistocene mammaIs from probIems invoIved with severa individuaIs the Ranch0 Ia Brea at the Los AngeIes experienced in orthopedic surgery. My Museum, where there are many thousands chief obIigations are to the members of the of Iimb bones and peIves, chieffy of the staff at Hamann Museum of Western giant woIf and sabre-tooth. I have exam- Reserve University. Dr. Todd came to Los ined the entire coIIection of great ground

* I am under specia1 obIigation to members of the staff of Hamann Museum, Western Reserve University, CIeveIand. Ohio. for heIo in the interoretation of the Iesions described in this paper. Dr. T. Wingate Todd compared the fossil bones with specimens in the Museum and furnished photographs. Dr. C. Al Hamann sent very wekome financia1 aid with which the iIIustrations of this essay were secured. Dr. N. William Ingalls determined for me the angle of torsion in a series of tweIve seIected femora of the giant wolf. Submitted for pub- Iication September 13, 1928.

NEW SERIES VOL. IX. No. 2 Moodie-Studies in PaleopathoIogy A me&an Journal of Surgery 349

sIoths, sabre-tooth cats, and severa other of southern CaIifornia, during the PIeisto- species of mammaIs, and the Iuxations cene, an anima1 with a dislocated joint described here are about a11 there are. The wouId be so severeIy handicapped that his

FIG. I. Mirror drawing of pathologica peIvis of sabre tooth (Smilodon californicus), PIeistocene, Ranch0 Ia Brea, showing both rami. It is evident that pathoIogica1 changes are restricted to right ramus (shown on left in the picture). AI1 other parts of peIvis are normal. Drawing depicts obIique, ventra1 view of pelvis, with diseased, distorted acetabulum, and surrounding areas, to left. On right of picture the left acetabulum and peIvic ramus shown, reflected in a mirror, indicated by rectanguIar fieId. Eburnated area of diseased acetabuIum shown to ex- treme left. Another view of pathoIogicaI ramus shown in Fig. 9. Drawing by John L. Ridgway.

greatest number of Iuxations, partia1 and continued existence wouId be very doubt- complete, occur among the giant woIves. fu1. He wouId soon faI1 a prey to his It wiI1 be at once evident that in a terri- enemies. tory teeming with enemies, as was this part I have measured severa hundred femora

350 American Journal of Surgery Moodie-Studies in PaIeopathoIogy AUGUST, ,930

of the giant woIf with an osteometric count is based on a survey of an enormous board, and have determined the degree of amount of materia1. AI1 comparative state- torsion with a tropometer Ioaned me by the ments have been checked again and again

FIG. 2. Wolf femora showing examples of Iuxations. Pleistocene of the Ranch0 la Brea. AI1 specimens in the

Los Angeles Museum. A = SmaII woIf femur, 210 mm. in Iength, with angIe of torsion of 7.5’, showing changes in form of head

resuIting from fracture in Iower one-third. The shaft is unusuaIIy short and straight. Another femur, 270 mm. in length, longest femur in collection, is uninjured, but shows angIe of torsion of onIy 2.5’. It is not certain that the short femur shown in “A” is of same species as others figured, it being impossibIe to teI1 the effect the injury has had on the growth of bone.

B = Right femur of giant wolf, Aenocyon dirus, an extremeIy rare condition, viscera1 aspect, showing deform- ing effect of articuIation in absence of C put femoris. Length of femur 230 mm., angle of torsion cannot be determined. Compare with kangaroo femora shown in Fig. 5.

c = Same bone, anterior aspect. D = Right femur of giant woIf, Aenocyon dirus, showing deforming effect of acquired luxation due to vioIence.

Lower portion of art&dating surface is eburnated. Its extent on to shaft of femur may be judged from “E.”

The Iength of the bone is 256 mm., with a degree of torsion of 8+“. The peIvis shown in Fig. 3 is definiteIy ascer- tained to beIong with this femur, aIthough it was found isolated. It matches perfectly. It is cIear that the head of the femur was compIeteIy disIocated from the acetabuIum and formed a faIse joint. The Iuxation was intracapsular. The Linea aspera is extensive, doubtless in response to the Iuxation.

E = Same femur shown from inner aspect. Inferior articuIar surfaces are not seriousIy affected.

San Diego Museum, in an attempt to and every care has been taken to diagnose determine the factors underIying Iuxation. the Iesions in an open-minded way. I examined, individuaIIy, 1945 femora of the sabre-tooth tiger, as we11 as a11 other REVIEW OF LITERATURE

limb bones of this species, in&ding the There does not exist in the literature of metapodiaIs, to the number of many paIeontoIogy, which I have seen, any thousands so that the accompanying ac- discussion of PIeistocene or earIier Iuxa-

NEW SERIES VOL. X. No. 2 Moodie-Studies in PaIeopathoIogy A m&can Journal of Surgery 35 I

tions. Baudouin (1907) after an extensive pre-CoIumbian luxation from southern outline of congenita1 Iuxations gives an account of four NeoIithic femora which

Patagonia in which the acetabuIum is compIeteIy destroyed and a new articuIar

FIG. 3. Right femora of giant wolf, showing different forms of head in A and c in norma bones, and in 1% articular part of femur showing luxation. Femur in “c” is 270 mm. in length with angle of torsion of 5“. AI1 three femora believed to represent Aenocyon dims.

he thinks belong with this type of disIoca- tion. Changes in the heads of the femora Iead the author to this cIassification, but he does not cIearIy differentiate from the simiIar conditions foIIowing proIonged sepsis.

Fox has described one exampIe of acquired Iuxation in a captive wiId mamma1 but does not discuss the bone changes.

Job’s paper (1891) is of importance. After a review of the Iiterature and a dis- cussion of Broca’s tropometre, he describes a new instrument, the trepsimetre, for the determination of torsion. The norma human femur has an average degree of torsion of 12D, a maximum of 25’ and a minimum of 3’_ Short femora have a greater angle than long; the Ieft more than the right. PathoIogicaI femora (fractures, osteomyeIitis and genu vaIgum) are subject to Iuxation. A femur with an OsteomyeIitis has a torsion angIe of 49’.

Verneau (1903) describes and figures a

area extending verticaIIy in a wide trough about two-thirds the Iength of the peIvis. There is no evidence of eburnation. The femur is not described.

A pre-CoIumbian peIvis from Peru showing arthritic changes due to luxation is in the Peabody Museum of AnthropoI- ogy at Harvard University.

TYPES OF LUXATIONS SEEN IN

PLEISTOCENE MAMMALS

There are, of course, two genera1 types of Iuxations to consider, and into these groups certain of my specimens naturaIIy faI1. ExampIes of congenita1 Iuxation are entireIy unknown among vertebrates other than man. Baudouin (1907) speaks of the condition as the “MaIadie anthropologique par excellence !” When I first came to the Los AngeIes Museum several years ago the first thing to attract my attention was the woIf femur shown in Figure 2,

B and c, and the thought that flashed into my mind was congenital luxation!

I heId this opinion for some years and it the peIvis accompanying the woIf femur seemed to be confirmed by conditions in an was made through the Los AngeIes coilec- ad& kangaroo but subsequent study tions without success.

352 American journal ot Swev Moodie-Studies in PaIeopathoIogy AUGUST, 1930

FIG. 5. Femora, peIves and sacrum of a recent kangaroo, which in Iife had acquired considerabIe reputation as a “boxing kangaroo” in one of the Los AngeIes Zoological Gardens. SkeIeton in Los AngeIes Museum.

A = Right femur showing effect of (congenitaI?) luxation and consequent lack of &put femoris in producing new articular surface with associated sur- face on peIvis. Length of femur 248 mm.

B = Left femur. c and D = Right and left peIves, with greatly

modified acetabulum, and eburnation of new articular surfaces.

E = Sacrum.

Acquired Iuxations are those due to injury after or during birth, to disease, to an exaggerated degree of torsion of the shaft of the femur or humerus; thus render-

FIG. 4. Fragmentary right pelvis of giant wolf which is exactIy matched with femur shown in Fig. I, D and

ing Iuxations easier to acquire, or to a

E. The fragment is 159 mm. in length. The acetabu- combination of two or more factors. I

ium is aImost obIiterated, and the functiona1, new, shaI1 describe an exampIe of Iuxation due to articuIar surface is extensively eburnated, with con- siderabIe hyperostosis.

vioIence in a giant woIf in which I have the good fortune to possess both the

brought another interpretation as outIined peIvis and the femur (Fig. 2, D and E and later. The absence of a Cuput femoris has Fig. 4). A most interesting exampIe of an another explanation. A special search for acouired Iuxation is seen in the DeIvis of a I 1

NEW SERIES VOL. IX, No. 2 Moodie-Studies in PaIeopathoIogy A mericnn Journal of Surgery 353

sabre-tooth (Fig. 9). There are numerous acquired Iuxation folIowing a chronic infec- exampIes of partia1 Iuxations accompanied tion (OsteomyeIitis?) of the hip. Traces of by more or Iess extensive arthritic Iesions. infection in the woIf femur and in the

A B

FIG. 6. ArticuIating areas in hip-joint of kangaroo.

A = Arrangement of trabecuIae in head of femur. B = Same in acetabular area of p&is.

A few of these wiI1 be described in this pIace.

BONE CHANGES IN A MODERN, HUMAN,

SEPTIC HIP

The search for human exampIes showing Ioss of head and neck of the femora, with which to compare our PIeistocene woIf (Fig. 2, B and c) and the kangaroo (Fig. 5), resuIted in the acquisition of the roentgeno- gram by Dr. Todd, shown in Figure 8, based on a septic hip in a young gir1 at CIeveIand. An examination of the femora1 head on the right of the picture shows Ioss of head and neck, and a pushing up of the femur so that the articuIation with the peIvis is on the tipper part of the femora1 diaphysis, exactIy as is to be seen in the wo1f and kangaroo mentioned previously.

This is not congenita1 Iuxation, but an

kangaroo femora and acetabuIa are eIse- where noted, and it is probabIy safe to state that the PIeistocene woIf femur (Fig. 2, B and c.), the kangaroo hip (Fig. 5) and the modern chiId (Fig. S), are a11 to be assigned to a simiIar cause, chronic infection of an unknown type.

An examination of the roentgenograms of chiIdren’s hips given by Retch ( rgr o) sheds some Iight on the present conditions, though none are so cIearIy paraIIeIed as the case shown in Figure 8.

COMPARISONS OF PLEISTOCENE WOLF

FEMUR WITH HUMAN BONE

The woIf femur (Fig. 2, B and c) may be regarded as of the same type of change as that shown in the chiId’s hip (Fig. 8), as well as that of the kangaroo (Fig. 5). These three exampIes, human, woIf and

354 American Journal of Surgery Moodie-Studies in PaIeopathoIogy Aucus+. 1930

kangaroo, ail show Ioss of head and neck with aImost the same gross features in aI1.

The femur (Fig. 2, B and c; Fig. 3, B) is

FIG. 7. Undetermined fragment of bone, possibly a portion of femur of giant woIf (Aenocyon dirus), showing false joint, a pseudarthrosis, with some excess caIlus. It has not been possible to associate this interesting fragment with any other bone in the coIIection. It indicates an ankylosed hip-joint with pseudarthrosis in upper one-third of femur. PIeisto- cene of the Rancho la Brea, specimen in Los AngeIes Museum at Exposition Park. X-ray by Dr. L. C. Kinney.

unique, and the Iarge coIIections from the Ranch0 Ia Brea show nothing simiIar. A specia1 search was made through the coIIections for the pelvis belonging with this femur without success.

The articuIar area of the bone (Fig. 2, B)

measures 30 mm. x 75 mm., and articuIa- tion seems to have been restricted to the Iower part of the area. There is no eburna- tion of any part of this area, but there is some excess caIIus at the Iower part.

I am unabIe to explain the deep pit at the top of the area. There are severa of them in the kangaroo femora (Fig. 5). It may be a necrotic sinus, though there is now IittIe evidence of a severe infection.

The Iower articuIar surfaces of the woIf femur are not affected, nor are those of the kangaroo.

We are fairIy safe in asserting that the Ioss of the head and neck in the fossi woIf, the kangaroo and the chiId was due to the same cause in aI1, sepsis. The nature of the sepsis in the PIeistocene exampIe cannot be determined.

FEMORAL TORSION CONSIDERED AS A FACTOR

IN LUXATION

It is a recognized fact that in the human femur there is normaIIy about roe to 12~

anteversion of the head from torsion of the bone, and in a very Iarge percentage of cases of congenital disIocation of the hip it exists to a much more marked degree, even

as much as 9o”, so that it is beIieved that in the cases of marked torsion deformity, the deformity is the cause of the dis- Iocation, and that probabIy the dislocation did not occur unti1 after birth from use of the deformed bone.

Job found torsiona angles in human femora from 3O to 25” which had no marked influence on Iuxation.

In the tweIve woIf femora studied by Dr. IngaIIs the angIes were found to vary between I’ and 13.5’. This series may be changed by a study of a Iarger series of bones, but the twelve were especiaIIy selected from severa hundred.

The method employed in determining the torsiona angIe in the woIf femora is essentiaIIy the same as that empIoyed for a study of human femora. The axis of the head and neck and the center of the head were determined by a Koordinatenzirkel. The Iong arms of the instrument were both in contact with the head at its greatest dia- meter and at the same time paraIIe1 with what has been considered the neck of the femur for present purposes. This concerns the outline of the neck as seen from above but onIy that portion on the same IeveI as the head. The Iower, ffaring part, running down to the Iesser trochanter has been dis- regarded. The neck in the wolf femora is so different from the human’condition that it was not possibIe to determine its midpoint by any direct measurement. The great

NEW SERIES VOL IX, No. 2 Moodie-Studies in PaIeopathology A merican Journal of Surgery 355

trochanter was aIso Ieft out of account so perpendicuIar to the Iong axis of the bone, what was considered as neck is that portion but this is of no consequence since the angIe of the bone from I to 1.3 cm. in extent, of obIiquity is smaI1.

FIG. 8. Pelvis of a white girI between seven and nine years of age. Her history is one of perfect ability in wall UI ltil between two and three years ago (November 23, 1g27), when she deveIoped an abscess of left hip and in bed for several months. Thereafter she had a marked limp. She had a11 of the symptoms of acute inflamma of hip-joint. It is cIear that there is complete absence of head and neck (right), without interference, at ec jiphyseal line of the great trochanter. Picture from Dr. T. Wingate Todd.

sing was tion the

immediateIy IateraI to the head, as seen from above, is the Iong axis of the bone.

The short middIe arm of the Koordi- natenzirkel, set at one half the anterior- posterior diameter of the head, marked the center of the head when the Iong arms were parallel with the axis of the head and neck. The placing of the arms paraIIe1 with the axis is pureIy a matter of judgment or appreciation and involves naturalIy the estimation of the desired axis and then the pIacing of the caIiper arms paraIIe1 to this. The angIe determined, the torsion angIe, is the angle formed by a Iine or pIane joining the determined points and the retrocon- dyIar pIane, which is tangent to the con- dyIes and the trochanteric region. The pIane in which the torsion angIe Iies is

Judging from a comparison of the angIe of torsion of the woIf femora with those found in human femora it is concluded that the angIe in the PIeistocene woIf is too smaI1 to have been of any significance in producing Iuxations.

TABLE I

A LIST OF WOLF (AEN~CYON DIRUS) FEMORA SHOWING

VARIOUS DEGREES OF TORSIOIi

Length Torsion (Mm.) (Degrees)

I. Normal tight. 225 6 2. Luxated right 256 8+ 3. Normal right 271 II 4. Normal left 253 IO- 5. Norma1 right. 238 6f 6. Normal right. 242 9 7. Norma1 left.. 258 5f 8. Norma1 Ieft.. 238 I- g. Norma1 right 270 *.5-

IO. Fractured left.. 210 7.5 I I. Normal right. 235 7.5+ 12. Norma1 left. 254 ‘3.5

FIG. 9. Right ramus of an aduIt sabre-tooth tiger (.%&don caZiforniczts) Pleistocene, Ranch0 Ia Brea, ‘showing Interal surface, extensively diseased. Luxation incompIete, and eburnated articular surface used is shown on Ieft of acetabular area. The extensive pathologica growths are without paraIIe1 in the field of PaIeopathoIogy. They are regarded as due tn severe bacteria1 infection foIlowing injury which produced the Iuxation. What kind of injury effected these changes is unknown, but it was severe. NearIy 2000 femora of the sabre-tooth were examined in an attempt to find the bone which beIonged with this peIvis, without S~CCCSS, Doubtless a discharging abscess poured out pus for a considerabIe period of time, and probably had not hcaIcd at the time of the death of the anima1. The opening in the floor of the acetabuIum is, in part, accidenta1. The bone was extremeIy thin and was fractured in collecting. PeIves and sacrum seIdom associated in sabre-tooth remains. OnIy in pathoIogica1 cases invoIving the sacroiliac joint are associated parts retained. PeIvis is shown from another angIe in Fig. 1. Specimen in the I .os AngeIcs Museum at Exposition Park.

NEW SERIES VOL. IX, No. z Moodie-Studies in PaIeopathoIogy A mrrican Journal of Surgery 347

TRAUMA AS AN IMPORTANT FACTOR IN

LUXATIONS

I beIieve injuries, often of a vioIent nature, to have been the most important and underIying factor in a11 of the PIeis- tocene Iuxations discussed in this paper. The presence, almost uniformIy, of ebur- nated surfaces in PIeistocene luxations, is an indication that the membrane of the joint has been disturbed by externa1 vioIence. Trauma underIies a11 of the dis- Iocations, both partia1 and compIete. In the case of the tiger peIvis (Fig, 9) the violence was folIowed by a severe infection, which invoIved not onIy the hip-joint but a11 the surrounding areas. The Iife these mammaIs Ied in those far-off PIeistocene days was one of rapine and constant alert- ness was necessary to avoid injury and death. The wonder is that more Iuxations are not seen, but an anima1 with a crippIing Iuxation wouId be severeIy handicapped.

acetabuIar part of the pelvis are shown in Figure 6, A and B. The architecture is cIearIy distorted, showing a condition of Iong-standing.

There are no changes in the articuIar surfaces of the lower ends of the femora.

A PLEISTOCENE PSEUDARTHROSIS

The identification of the fragment of bone shown in Figure 7 is in considerabIe doubt. I believe it to be a part of the femur of a giant wolf, but it is so changed by the excess caIIus on which the new articuIar surface was deveIoped that I cannot be sure. A short time ago I identified as a woIf femur a fragment of a sabre-tooth rib which was so greatIy changed by disease as to be aImost impossibIe to identify.

MODERN, BILATERAL LUXATIONS IN A

KANGAROO

A skeIeton of an aduIt kangaroo in the

This exampIe of a pseudarthrosis is unique among the PIetisocene mammaIia of the Ranch0 Ia Brea. Its description in this pIace is justified because its condi- tion indicates an ankyIosed hip. The Iength of the fragment is 120 mm. with a thick- ness of 58 mm. through the caIIus. The diameter of the shaft is 20 mm.

Los AngeIes Museum shows in the femora and peIves disturbances which may have foIIowed from sepsis. The anima1 was said to have been captured in Australia as an adult, and became an inmate of one of the zooIogica1 gardens of the city. There is no clinica history and we know onIy the end-resuIts in the skeIeton. No other parts of the body show any pathoIogica1 changes.

Both hips show exaggerated Iuxations with Ioss of heads and necks of the femora (Fig. 5, A and B). The conditions are quite simiIar to that described for the woIf (Fig. 2~ and c). The articuIar area meas- ures 23 mm. X 70 mm. and unIike the woIf shows an area near the middIe of intense eburnation. The ivory-Iike bone is more extensive on the peIves, where the acetabu- Ium has been filled with excess caIIus. Numerous openings in both femora and peIves doubtIess are necrotic sinuses. The acetabuIar area measures 43 mm. X 50 mm., fuIIy one-haIf of which is eburnated.

The upper surface of the caIIus (Fig. 7) is greatIy eburnated, though not so highIy poIished as other eburnated surfaces I have seen. The eburnated area is saddIe- shaped, measuring 30 mm. X 35 mm. Around its edges roughened bone suggests an intense preceding infection. I beIieve the bone to have been fractured immedi- ateIy beIow the anatomica neck, but extracapsular.

The roentgenogram shows the bone immediateIy below the eburnated area to be quite dense.

A TRAUMATIC LUXATION

The woIf femur (Fig. 2, D and E) showing the effects of a traumatic disIocation is compIete, measuring 256 mm. CarefuI measurements of severa hundred femora of Aenocyon show ranges in Iength of from 230 mm. to 270 mm., so the present exam- pie is a IittIe above the average. The torsiona angIe is 8+“.

Roentgenograms of a femora and the There is no way of expIaining just how

FIG. IO. A: Lower articuIar surface of right femur of Smilodon californicus, PIeistocene sabre-tooth from the Ranch0 Ia Brea, showing reduction of articular area by peripheral exostoses. PosteriorIy articutating surfaces are eburnated for distance of 50 mm. Area here shown had not been in use for some time before the death of the anima1 thus forming an exampIe of partia1 or incompIete Iuxation. MarginaI Iipping, posteriorly, more pronounced on right side of the bone and associated with disturbance in the popIitea1 space, above which on the right there is a large exostosis. Greatest diameter of surface depicted 85 mm.

B: Upper articuIar surface of tibia of giant wolf, Aenocyon dims, showing arthritic disturbances involved in partial luxation. PeripheraI Iipping more pronounced on Ieft in drawing due to injury represented by the Iarge exostosis. Area shown has diameter of 52 mm.

c: Upper articuIar surface of humerus of giant woIf showing almost compIete luxation brought about by extravagant growth of periarthritic lesions. Lips of bicipita1 groove ossified for considerabIe distance down anterior surface. OvaI area, shown in drawing, had been the onIy functioning articuIar surface for some time. Area is eburnated and worn aImost Aat. Associated scapuIa has been identified, and is shown in Fig. II, upper figure. Ova1 area has tong diameter of 30 mm.

D: Lower articuIar surfaces of pathoIogicaIIy coossified tibia and fibuIa of giant woIf. Joint highly diseased and articuIating surfaces deepened, ebumated and worn. Transverse diameter of surface shown is 54 mm.

E: Upper articuIar surface of humerus of giant woIf which had been fractured and in which severe osteomyekis had developed (see Ann. M. Hist., 8: 416, 1926). Disturbannces in articuIation due to necessity brought about by newIy estabIished angIe of torsion. Area is restricted, eburnated and imperfect, a partia1 luxation. Entire bone much shortened, having Iength of 180 mm., as compared with a Iength of 227 mm. of normaI bone.

F: Lower articular surface of incompIete femur of giant wolf. PartiaI Iuxation indicated by destruction of condyIe on the left. Surface on right was onIy one functioning and that was rendered imperfect by arthritic Iesions which had crept in from the sides. Numerous Iesions about and above joint surface indicate an intense infection due to injury which involved destruction of condyIe. Joint surface very imperfect.

u35sll

New SERIES VOL. IX, No. z Moodie-Studies in PaIeopathoIogy A me&an Journal of Surgery 359

this disIocation took pIace, but the Iife of a down onto the body of the diaphysis. The wild carnivore must have been repIete with head itseIf as shown in Figure 2~ has an scenes of vioIence. The present individua1 acuminate cap of new bone beIow which

.. . ..~ \..._^e j__ __ ,_

FIG. I I. Upper: Partially Iuxated joint in definite association of humerus and, scapula of giant wolf, PIerstocene of the Ranch0 la Brea. Head of humerus shown in Fig. IO, c. ArticuIar surface of scapuIa shows overIapping peripheral exostosis destroying serviceability of joint. ArticuIation confined to sharpIy marked crescentic area, highIy eburnated, on inner margin of fossa. This surface articuIates with ovaI, Aattened area shown in Fii. IO, C.

Middle: Eburnated striae in articular surface of uIna of Pleistocene wolf, with associated pathoIogica1 Iesions due to injury. WoIf bones show great variety of arthritic disturbances, much more than any other species, and they will be discussed and figured in another contribution. Length of bone, 140 mm. Effect is that of partial luxation.

Lower: PartiaI Iuxation in articuIar fossa of woIf uIna. OriginaI joint surface partIy buried by overlapping exostoses and it is on these that the humerus articulated. Origin of Iesions may be traced to injury to oIecranon. Length of bone (incomptete), 142 mm. Specimens in CoIIections of Los AngeIes Museum at Exposition Park.

was more fortunate than others, and was abIe to survive its crippIed state by activeIy, though painfuIIy, evading his enemies. After the pain had subsided and the pseudarthrosis formed, the anima1 was doubtIess as easiIy agiIe as others.

The eburnated area on this maIe woIf femur covers an area 25 mm. wide by 55 mm. Iong, incIuding a sIight area on the Iower part of the head, and extending we11

there is other new growth of bone. The growth of excess caIIus on the femur is greater than that shown in the peIvis.

There is no change in the articuIar sur- faces of the Iower end.

PLEISTOCENE WOLF PELVIS SHOWING

EFFECTS O+ LUXATION

I have the good fortune to have studied a femur (Fig. 2, D and E) and a pelvis (Fig.

FIG. 12. Large pool or pit at the Ranch0 Ia Brea on W&hire Boulevard, Los Angeles, as it appeared twenty years ago. It has not changed perceptibIy since. This pit made originaIIy for asphalt for road buiIding and bones:of PIeistocene mammaIs were cast aside. Further excavations subsequent to 1906 resulted in recovery of much material. When I visited the locality in 1909 eIephant bones were being extracted from bank to right of b. The entire area, something over 30 acres, has been given by the owners to the county as a PIeistocene Park, under the direction, of the Los AngeIes Museum.

a: Water and oil cover Aoor of pit to undetermined depth. Gas bubbles may be seen breaking surface in back- ground on right.

b: AsphaIt seen at east end of pit. Tar fairIy soft and viscid. It forms a most wonderful trap for unwary animaIs, giving an insight as to how PIeistocene mammaIs were caught.

U36oll

NEW SERIES VOL. IX, No. 2 Moodie-Studies in Paleopathology A merican Journal of Surgery 361

4) of a giant woIf which definiteIy match, though found separate.

As shown in Figure 4 the acetabuIum is

FIG. 13. Left ramus, adult sabre-tooth peIvis, Ranch0 la Brea, showing great roughening and thickening in area about acetabulum, due to infected injury, and resuIting in partial Iuxation of hip. Norma1 ace- tabulum practically circular, measuring about 50

mm. in diameter, but this acetabuIum has area of 55 mm. x 70 mm., and is quite shallow, whiIe norma acetabuIum is quite deep. Upper (to right) one-haIf of articular area functional, and highly eburnated, with maximum diameter of 30 mm.

Entire Iength of peIvic ramus 30.5 cm. Los AngeIes Museum of History, Science and Art, Exposition Park.

compIeteIy destroyed and fiIIed in with excess caIIus. On this excess caIIus is an eburnated area, 25 mm. x 45 mm., saddIe- shaped, on which the neck of the femur (Fig. 2, D and E) articulated. As in the case of the pseudarthrosis (see Fig. 7) the margins of the eburnated area are beset with greatIy roughened bone. The head of the femur aIso shows changes.

The peIvis (Fig. 4) is fragmentary, measuring 160 mm., as compared with a measurement of 223 mm. for the compIete bone.

Another exampIe of compIete Luxation is to be found in the peIvic bone of the giant wolf in which the acetabuIum is reduced

from the norma by 3 mm. in diameter, with an enormous amount of caIIus, roughened by numerous exostoses and

FIG. 14. Luxation in tibia of a coyote, Ranch0 Ia Brea. Left: Articular area onIy sIightIy reduced by

margina osteophytic growths. x I. Right: Right tibia of PIeistocene coyote, Ranch0 Ia

Brea. Articular surfaces greatIy reduced, to area of IO mm. on one side, to the right, and to area of 7 mm. on the other. This smaI1 area highly eburnated with series of parallel striae. Margina osteophytes very pronounced, indicating arthritic disturbance of some severity. x I. Los Angeles Museum of History, Science and Art, Esposition Park.

necrotic sinuses. The acetabuIum shows no sign of wear, and an area on the upper side measuring 13 X 42 mm. shows eburnation as if the neck of the femur had articuIated on this surface, in this case Ieaving the acetabuIum without much change.

AN UNUSUAL PATHOLOGICAL CONDITION

The foIIowing is an unusuaI pathoIogica1 condition in the peIvis of a sabre-tooth regarded as due to infection, folIowing a vioIent trauma, which aIso resuIted in Iuxation.

The sabre-tooth peivis, shown in Figures I and 9, is the most strikingIy pathoIogica1 object in the coIIection of Ranch0 Ia Brea fossiIs, preserved in the Los AngeIes Museum. The infection, foIIowing trauma, confined its ravages to the right peIvic ramus. The acetabuIum of the diseased side measures 85 mm. in diameter, as compared with a diameter of 48 mm. in the normal side (see Fig. I).

The peIvis is probabIy that of an aduIt male, and the injury may have been received in an encounter with another sabre-tooth. The entire acetabuIar region resembIes in its appearance that of a Iava bed. The several vesicuIar pockets, meas- uring 17 mm. in depth and 36 mm. in

362 A merican JournaI of Surgery Moodie-Studies in PaIeopathoIogy AUGUST, rgzjo

Iength, recaI1 bIack Iava bubbIes. The numerous osteophytic growths are IargeIy rounded near the acetabuIum, but out on the iIium they are fenestrated and spinous. The articuIar surface for the head of the femur is restricted to an eburnated area in the dorsa1 portion of the acetabuIum (Fig. 9). The bone forming the bottom of the acetabuIum is of paper-Iike thinness, and aIthough broken in the specimen during coIIection, it was doubtIess compIete dur- ing the Iife of the anima1. The dorsa1 aspect of the acetabuIar region presents a thickness of 44 mm. as compared with 28 mm. of the norma side. This surface is covered with ramifying vascuIar channeIs and foramina, recaIIing in appearance the surface features of an osteosarcoma in an ancient Egyptian peIvis, described by Ruffer. Like that specimen, too, the tiger peIvis presents a pubic thickness which may we11 represent a tumor, but I think from the genera1 aspect of the bones that a11 of Iesions were due to infection, foIIowing trauma, and are not neopIastic.

The peIvis was isoIated and no associated bones, such as the sacrum and femur, have been identified in the coIIections. AIthough I have examined individuaIIy a11 of the 1945 femora of the sabre-tooth,

contained in sixty museum trays, during a count to determine the incidence of disease (1.64 per cent) I found no trace of a femur showing characters such as wouId be demanded by the articuIation with this disturbed acetabuIum. The femora present evidences of fracture, l pressure atrophy, l arthritis deformans,3 sIight sub- periostea1 exostoses,‘~ and partia1 Iuxation of the Iower end,’ but not an upper Iuxa- tion. I made no effort to try to match any of the 1046 sacra with this peIvis.

A Iuxation in a tiger peIvis, without infection, is shown in Figure 13. The acetabuIum is extremeIy shaIIow and the Iuxation seems to have been of Iong standing.

REFERENCES

ALTMANN, F. Untersuchungen ueber die Torsio femoris und damit im Zusammenhang stehende Frage. Zeitscbr. f. Anat. u. Entwickelungs., 75: 82, 1924.

BAUDOUIN, M. La prthistoire de Ia Iuxation congenitaIe de Ia hanche. L’Homme Prehistorique, Paris. Tome 7, 129-139, 2 figs., 1907.

Fox, H. Disease in captive wiId mammaIs and birds. The skeIeton and its joints, Chap. XII p. 343,

1923. JOB, R. l?tude de Ia Torsion normaIe et pathoIogique du

femur. These, Lyon. 1891. ROTCH, T. M. The Roentgen Ray in Pediatrics. rgro. VERNEAU, R. Les anciens Patagons. Contribution a

I’I%ude des Races priroIumbiennes de I’Am6rique du Sud. Publike par Ordre de S. A. S. Ie Prince AIbert 1~~. 1903. PIate x, 4. Pseudarthrose iliaque consecutive B une Iuxation du femur. Ancienne skpubure de Sauce BIanco (Rio Negro) Argentine.

BOOK REVIEWS

RADIOGRAPHIE NEPHRO-CHOLECYSTIQUE.

By Dr. ManueI de Abreu, BraziIian Inst. of Sciences & Acad. of Med. Rio de Janerio. 158 pp. 54 cuts, & 54 drawings. Paris, Masson & Cie, 1930.

The reader finds this a very interesting work on the radiographic diagnosis of gaII-bladder and renaI disease, especiaIIy with reference to the differentia1 diagnosis. The differentia1 diag- nosis of abdomina1 concretions is often com- plicated, particuIarIy gaII-bIadder and renaI caIcuIi. The author has studied very carefuIIy

the various angIes of incidence, anterior, pos- terior, oblique and combined; and has estimated the volume and shape of the kidney in these various positions. He has made a carefu1 comparison of vesicuIar and renaI shadows, especiaIIy after turning the patient in the obIique position so that the zone of the renaI peIvis is thrown far away from the shadow of the gaII-bIadder region. The author caIIs attention to the advantage of pyeIography in the TrendeIenburg position, the renaI peIvis and the caIyces being demonstrated more easiIy in this position, and recommends renal