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October 3, 2012 9:07 am

Are These Two Toes the World’s First Prostheses?

This summer Oscar Pistorius ran in the able-bodied Olympics using two prosthetic legs. It was a remarkable achievement, and while he didn’t medal, it was incredible to see a man with no lower legs compete against the top athletes in the world.

But prosthetic devices have a long history. Much longer than many people realize. This is probably the world’s first prosthesis—a wooden toe that dates back to before 600 B.C. There is another quite like it from around 950-710 B.C., and together they are the two oldest prostheses ever found.

Determining whether this was a prosthesis, or simply part of a wooden sculpture isn’t easy. The Lancet explains:

To be classed as true prosthetic devices any replacement must satisfy several criteria. The material must withstand bodily forces so that it does not snap or crack with use. Proportion is important and the appearance must be sufficiently lifelike as to be acceptable to both the wearer and those around them. The stump must also be kept clean, so it must be easy to take on and off. But most importantly, it must assist walking. The big toe is thought to carry some 40% of the bodyweight and is responsible for forward propulsion although those without it can adapt well.

It certainly seems to have been used. As Discovery writes, “Both fake toes show significant signs of wear. Moreover, they feature holes for lacings to either attach the toes onto the foot or fasten it onto a sock or sandal.” But that’s simply not enough.

The ultimate test, however, involved actually trying the toe on. Yes, two volunteers who were missing their big toes put the ancient wooden toe on and walked around with it wearing replica Egyptian sandals. Here’s The Lancet again:

My own research used two volunteers with similar amputation sites and suggested that replicas of both ancient Egyptian false toes performed extremely well. Neither design should be expected to be completely efficient in emulating the flexion of the normal left big toe when pushing off. However, high efficiency was recorded by one volunteer when wearing the replica cartonnage prothesis and also when wearing the wooden one (both worn with replica Egyptian sandals). More importantly, no significant elevation in pressure under the sole was recorded although both volunteers found the articulated wooden design to be especially comfortable.

The volunteers walked 10 meters with the toe on, their footsteps were recorded with a special mat. Cameras also captured their strut. And it turned out that when wearing these prostheses along with the replica sandals, the volunteers could get 87% of the flexion that their normal left toes achieved.

Not exactly Pistorius’s Cheetah blades, but far better than walking about with no toe.

More from Smithsonian.com:

Does Double-Amputee Oscar Pistorius Have an Unfair Advantage at the 2012 Olympic Games?
The Rise of the Bionic Human



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