Abstract
This paper describes the curious case history of the famous and rare Klippel Feil syndrome type II, identified in the skeleton of a young Slavic soldier who died in 1946. It is a very interesting case given the fusion of the C1 and C2 cervical vertebrae, which prevented the young soldier from rotating his skull while alive. Klippel–Feil syndrome is a rare osteopathology and involves fusion of the vertebrae of the spine and is linked to other pathologies that indicate the presence of this pathological condition. In the present study, several basic investigations were carried out: a macroscopic observation to document the abnormalities throughout the rest of the skeleton, a morphological one to determine the identifying anthropological analysis, a pathological one to determine the pathologies present and a radiographic one to diagnose and confirm the pathology. Studying the pathologies of the past is fundamental in order to know the evolution and behaviour of the disease today, and the investigations carried out in this case study determined what the limitations of the young soldier were, how this disease may have influenced his activities as a soldier during World War II and through which therapies the syndrome may have been treated in such an important historical period.
Highlights
In the summer of 2019, the Institute of Forensic Medicine of Bari and the ForensicAnthropology Laboratory of the same department undertook research work within the Monumental Cemetery of Bari that led to the discovery of 93 skeletal remains of Yugoslavian origin, most belonging to soldiers missing for a very long time who died during the SecondWorld War in the famous Prison Camp of Torre Tresca (Bari, Puglia)
Klippel–Feil syndrome is a rare complex congenital pathology, and its main feature is the fusion of two or more cervical vertebrae associated with other possible skeletal abnormalities mainly affecting the spine [28]
Congenital fusion of two vertebrae into one block (C1, C2), as in the present case, occurs when there is an abnormal division of the somites, resulting in a disorder known as Klippel–Feil syndrome [29,30]
Summary
World War in the famous Prison Camp of Torre Tresca (Bari, Puglia) Among these remains was the skeleton of a young soldier who died in 1946, probably from complications of a rare disease. This disease had been sporadically documented in anthropological literature as Klippel–Feil syndrome, in this case type II with fusion of the first and second cervical vertebrae. The different manifestations due to the different genetic pathways made it possible to define three degrees of cervical fusion (I–III): Type I: the classic Klippel–Feil syndrome with several cervical and upper thoracic. Type III: fusion of cervical vertebrae coexisting with segmental vertebral defects in. Type III: fusion of cervical vertebrae coexisting with segmental vertebral defects in the the thoracic and lumbar regions [2].
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