This Poor Hunter-Gatherer Had His Leg Surgically Amputated 31,000 Years Ago

A 31,000 year-old skeleton has been discovered to be the oldest case of a limb amputation ever found.

According to a paper published on September 7 in the journal Nature, the skeleton was that of a young individual from the island of Borneo—possibly a child—who had the lower third of their left lower leg surgically amputated. They not only survived the operation but lived for a further six to nine years.

Until this discovery, the earliest known case of successful amputation came from a 7,000-year-old skeleton of a male from France, who was discovered to have had his left forearm amputated just above the elbow.

"It was a huge surprise that this ancient forager survived a very serious and life-threatening childhood operation, that the wound healed to form a stump, and that they then lived for years in mountainous terrain with altered mobility—suggesting a high degree of community care," paleopathologist and co-author of the paper, Melandri Vlok from the University of Sydney, said in a statement provided to Newsweek.

The reason that the individual's leg had to be removed is currently unknown, however, the authors suggest in the paper that the amputation was unlikely to have been caused by an animal attack or other accident, as these typically cause crushing fractures.

Traumatic injuries accounts for about 45 percent of amputations in modern times, according to Johns Hopkins Medicine, with most of the rest resulting from conditions that affect blood flow in certain extremities, such as diabetes and peripheral arterial disease. A very small proportion are a result of cancer in a limb, infections like sepsis, and genetic deformations.

A huge amount of skill is required to amputate a limb, as blood vessels need to be tied to prevent hemorrhage, surrounding muscles moved so that they aren't damaged, and, of course, the bone needs to be sawed through.

There is also a lengthy recovery period during which the patient is vulnerable to infections, bleeding and movement issues.

"That this child survived the procedure and is estimated to have lived for many years afterwards is astounding," said Charlotte Ann Roberts, a bio-archaeologist at Durham University in the U.K., in an accompanying News and Views article, also published in Nature.

"The hunter-gatherer community in which this person lived would have been relatively mobile while foraging and hunting for food, and this would have made the individual's recovery process very challenging, considering how people recover from amputations and the need for care, rest, healing and rehabilitation," said Roberts.

Despite their lack of modern painkillers, disinfectants or antibiotics, the amputee survived, and lived for multiple years afterwards.

"The remodeled bone at the amputation site, preserves clear signals of bone growth matching clinical instances of surgical amputation, completely lacking skeletal signals of infection or bone crushing otherwise associated with accidental injury or animal attack," Tim Maloney, lead author of the paper and Research Fellow at Griffith University's Center for Social and Cultural Research in Australia, told Newsweek.

"The exceptionally clean, neat and oblique surfaces of the remaining left tibia and fibula, preserve a clear instance of a sharp amputation surface," he said. "Remodeled bone [as old as] six to nine years has formed, and partially fused, as the surviving individual put some pressure on the area throughout their life, likely using the lower left leg as a 'stump.'"

According to Maloney, in Western societies, amputation resulted in death as often as not until antiseptics became widely used within the past century.

"This [discovery] implies a fair likelihood that this technological development was also possessed by the ancient surgeons of Borneo, who likely also stemmed blood loss and managed shock," Maloney said.

"It is highly unlikely for an individual to survive an open wound of this nature, without a high degree of antiseptic, antimicrobial and even pain relief remedies—we suspect likely accessed via the immense plant biodiversity in the tropical rainforest environments of the area," he said.

"Maloney and colleagues' study is important because it provides us with a view of the implementation of care and treatment in the distant past," wrote Roberts.

"It adds to other research about community care in historical contexts, and, like other work, challenges the perception that provision of care was not a consideration in prehistoric times. That this person was given a deliberate burial in a cave when they died perhaps confirms that the care provided in life by this community continued after a person's death," she said.