Injuries to the Skeleton due to Prolonged Activity in Hand-to-Hand Combat

Two complete skeletons from the Hamman-Todd collection of the Cleveland Museum of Natural History (CMNH) show a suite of pathological lesions that suggest the individuals had been involved in boxing or other hand-to-hand combat. These lesions were studied and compared with medical and autopsy records. The aims of the research were to estimate the accumulated damage to the bones over time, to characterize the different types of the damage, and to establish criteria for hand-to-hand combat or violence for archaeological material. Our inspections showed that besides the muscle markings developed and the numerous healed fractures that are expected when someone is involved in such activities, other types of lesion are present that are helpful for a proper differential diagnosis. These are: degenerative changes at the lesser tuberosity of the humerus; focal necrotic changes/bone growth on the trochlea of the humerus; necrotic changes on the distal head of the ulna; bony patches on upper limb bones only; secondary centres of ossification failing to fuse (mainly in vertebrae and acromion); a huge conoid tubercle on the clavicle; bony spurs on the distal articular heed of the metacarpals; necrotic changes on the femoral head next to the fovea and on the roof of theacetabulum; and a developed bony ridge for the attachment of the iliotrochanteric ligament. Finally, we propose a set of criteria that will help to identify people in archaeological material who were involved in hand-to-hand combat.