Two ancient Egyptian artificial toes may be oldest known prostheses

A series of walking tests that used replicas of two ancient Egyptian artificial toes suggest that they could be the world’s first prosthetic body parts.

Researchers from the gait laboratory at Salford University’s Centre for Rehabilitation and Human Performance Research, Salford, UK, used replicas of an artificial big toe made from cartonnage — a type of papier maché — and a three-part wood and leather toe that laced together and was strapped onto the foot, as well as ancient leather Egyptian style sandals. The replicas were assessed on two volunteers exhibiting complete disarticulation at the first metatarsophalangeal joint of the right foot.

The participants walked on a 10-m walkway barefoot, in their own shoes and while wearing the replicas with and without the sandals. Researchers tracked their movements using 10 cameras and used a gait mat to measure the pressure of their footsteps. They recorded the 10 best walking trials, using the normal left foot as the control.

When wearing the sandals with the cartonnage replica, one of the participants achieved 87% of the flexion achieved by their normal left toe, while the wood and leather design produced nearly 78%. However, the participant could not push off the prosthetic toe as well when not wearing the sandals. Researchers found that the second participant was able to produce between 60% and 63% flexion wearing the replicas with or without the sandals.

Pressure measurements showed that there were no overly high pressure points for both participants, indicating that the false toes were not causing any undue discomfort or possible tissue damage. The pressure being applied under the foot rose sharply when the participants wore the replica sandals without the false toes.

“It was very encouraging that both volunteers were able to walk wearing the replicas,” Jacqueline Finch, PhD, of the University of Manchester, stated in a press release. “Now that we have the gait analysis data and volunteer feedback alongside the obvious signs of wear, we can provide a more convincing argument that the original artifacts had some intended prosthetic function.”

The cartonnage toe, from the Egyptian Galleries in the British Museum, London, UK, has been dated to before 600 BC. The wood and leather toe is exhibited in the Egyptian Museum in Cairo, Egypt, and is dated to between 950 and 710 BC.

For more information:

Finch JL, Heath GH, David AR, et al. Biomechanical assessment of two artificial big toe restorations from ancient Egypt and their significance to the history of prosthetics. J Prosthet Orthot. 2012;24:181-191.

Disclosure: Finch has no relevant financial disclosures.

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