Reply to: Common orthopaedic trauma may explain 31,000-year-old remains

Melandri Vlok, Tim Maloney, India Ella Dilkes-Hall, Adhi Agus Oktaviana, Pindi Setiawan, Andika Arief Drajat Priyatno, Marlon Ririmasse, I. Made Geria, Muslimin A.R. Effendy, Budy Istiawan, Falentinus Triwijaya Atmoko, Shinatria Adhityatama, Ian Moffat, Renaud Joannes-Boyau, Adam Brumm, Maxime Aubert

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We appreciate the accompanying technical Comment by Murphy et al. 1—a group of practicing orthopaedic surgeons—on our original paper 2. However, we strongly disagree with their conclusion that a reductionist approach was taken in the diagnosis of surgical amputation in a 31,000-year-old individual (TB1) from Borneo. We note that a complete systematic differential diagnosis was indeed completed(Extended Data Table 1); this process involved careful consideration of the most common and banal conditions first, such as accidental fracture, before considering the possibility of more rare and unusual circumstances. Through this iterative process, fracture was first eliminated as a possibility, followed by natural causes of amputation.
Original languageEnglish
Pages (from-to)E15-E18
Number of pages4
Issue number7952
Publication statusPublished - 16 Mar 2023


  • orthopaedic trauma
  • archaeological human remains
  • accidental fracture
  • surgical amputation
  • archaeological bone


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