Tibial surgery in ancient Peru

Area of Science:

• Paleopathology
• Bioarchaeology
• Surgical History

Background:

• The pre-Columbian site of Kuelap in Peru has yielded numerous examples of cranial trepanations.
• Ancient Andean populations, particularly the Chachapoya, were recognized for their surgical skills and healing practices.

Purpose of the Study:

• To document and analyze a unique instance of post-cranial surgical modification on skeletal remains.
• To investigate the surgical techniques and potential therapeutic intent behind this rare procedure.

Main Methods:

• Analysis of two individual skeletons from Kuelap exhibiting anthropogenic modifications.
• Comparative study with known cranial trepanation techniques from the region.
• Examination of skeletal evidence for signs of healing and infection.

Main Results:

• Identification of the first documented case of post-cranial trepanation using an adjacent drilling technique in the region.
• Surgical modification located on the distal tibial metaphysis of both individuals.
• Absence of evidence for long-term healing, suggesting an acute intervention.

Conclusions:

• This case represents an innovative, albeit unsuccessful in the long term, therapeutic intervention by ancient Andeans.
• The procedure was likely an attempt to treat osteomyelitic infection of the tibia.
• Highlights the advanced, yet sometimes limited, surgical capabilities of pre-Columbian Andean populations.