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5 - Trauma

The document discusses trauma patterns found in human skeletal remains, noting that trauma provides insights into risks of accidental injury, violence, and warfare. It describes different types of fractures like greenstick, stress, transverse, spiral, and depressed fractures. Cultural factors can influence trauma patterns based on habitual activities, occupations, transportation methods, and risky behaviors.

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50 views51 pages

5 - Trauma

The document discusses trauma patterns found in human skeletal remains, noting that trauma provides insights into risks of accidental injury, violence, and warfare. It describes different types of fractures like greenstick, stress, transverse, spiral, and depressed fractures. Cultural factors can influence trauma patterns based on habitual activities, occupations, transportation methods, and risky behaviors.

Uploaded by

MASmuffin
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PPT, PDF, TXT or read online on Scribd
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Chapter 5: Trauma

Trauma

• Next to dental disease and arthritis, the


most common pathology found in human
skeletal remains
Importance of Trauma
• Frequency and location of bone fractures
provides insight into risks of accidental
injury (falls, occupational injuries)

• Trauma provides direct evidence of


violence and warfare
Example
• Comparison of ancient Nubian skeletons
with 19th Century Industrial England
• England: ankle fractures, hand fractures
common
• Nubia: “Parry fractures” common in males;
ankle/hand fractures rare
Trauma Includes:
• Bone Fractures
• Dislocation of Joints
• Disruption of Nerve/Blood Supply

*Cultural modification (cranial deformation,


tooth modification, tattooing, scarification)
is also classified as “trauma” [so is surgery]
Culture plays a major role in
trauma patterns
• Habitual Activities
• Sports
• Transportation (automobile accidents)
• High Risk Occupations

Examples: Sky Diving, Rollerblading,


Skiing, Motorcycle Riding
Risky Behavior: Motocross

-Quote from
Chad Robbins
age 17:

New York Times September 2, 2002


In any skeletal population you can
expect to find differences in trauma
patterns between
• Males and females
• Adults and children
• Different occupational groups

These differences are important in


understanding the cultural patterning of trauma
What causes fractures?

• Direct blow to bone


• Bending, twisting, pulling, compression
• Structural failure (osteoporosis, other
diseases that weaken bone)
Two basic types of fractures:
Complete and Incomplete
• Complete: ends of bone are completely
separated by the fracture
• Incomplete: Ends of bone still connected.
– Common in children, and known as “green
stick” fractures
– “Stress fractures” the other common form of
incomplete fracture
Greenstick
Fractures

clinical
radiographs
Stress Fracture
of Tibia

stress fractures are


only detectable in
radiographs
Paleopathological Record
• Greenstick and stress fractures, both of
which heal and remodel well, will probably
not be found.
Common Fracture Types
Long bone fractures
– Transverse (straight
across)
– Oblique (angled)
– Spiral (rotation)
Additional Fracture Types
Comminuted Fracture
• Bone broken into
more than 2
pieces

• Crushing injuries
commonly result
in comminuted
fractures
Compound (Open) Fracture
• When bone exposed
through the skin
• DANGEROUS, due to
infection risk
• 40% mortality in 19th
century Europe

Healed compound fracture with infection


Depressed Fracture
• Typically found in the
skull
• Usually Result of blow
with blunt object

Healed depressed skull fractures


Compression Fractures
• Most common in spine
• Causes: falls, vertebrae
weakened by osteoporosis
Avulsion (Traction) Fractures
• Where a bone is pulled with such
force that it fractures off
Pathologic fractures
• When bone, weakened by
disease, fails
– Osteoporosis,
oseteogenesis imperfecta,
tumors

Fracture of femoral neck


“Hip Fracture”
Some fractures have been given
specific names

• Colles’ Fracture
• Parry Fracture
• Grenade-thrower’s Fracture
• Sprinter’s Fracture
• “Midnight Fracture”
Colles’ Fracture
(Abraham Colles, Irish Surgeon 1773-1843)
• Transverse fracture of the distal end of the
radius with displacement of hand
backward and outward
• One of most common fractures (“wrist”)
• Results from falling on outstretched hand.
(Accidental)
Colles’ Fracture
Parry Fracture
• Also known as “nightstick” fracture or
“fending” fracture
• Fracture of shaft of ulna when struck by a
club or other object
• More common on left side than right
Ancient
Parry
Fracture

Parry Fracture
Modern Parry
with splint,
Fracture
Egypt, 2500 BC
Grenade Thrower’s and “Midnight
Fracture”

• Grenade Thrower’s: neck of humerus from


weight of grenade
– WWII – cast iron grenades

• Midnight Fracture: ?
Sprinter’s Fracture
• avulsion fracture of
anterior inferior
iliac spine of pelvis
Effects of Fractures
• Fractures tear blood vessels in bone, in
periosteum and endosteum, and in bone
marrow, resulting in
1. A blood clot
2. Necrosis- death of bone cells that are cut
off from their blood supply

But bone is living tissue, and can heal


itself………………
Fracture Healing

Primary Secondary
bony bony callus
callus
Healed long bone fractures
Peru, Prehistoric

(Hrdlicka Collection)
Complications with Fracture
Healing

• Displacement and
Angular Union of
broken ends
• Can result in
abnormal joint angles,
leading to arthritis
Complications with Fracture
Healing

• Shortening of
fractured limb bone
Complications with Fracture
Healing

• Incomplete union of
broken ends
(nonunion)
• Pseudarthrosis: a
false joint with
articular cartilage
Less common fracture
complications

• Infection: rare, except in compound


fractures and penetrating wounds

• Disruption of blood supply, necrosis and


nerve damage
Identifying Fractures in
Archaeological Remains

• Healed or Healing
Fractures
– Can be obvious
(fractures with
angulation, large
callus, etc.)
– Or can be subtle (well-
healed fractures,
greenstick fractures)
Find the healed fracture in this hand
Identifying Fractures in
Archaeological Remains

• “Fresh” or “Perimortem”
Fractures
– Perimortem= at or around
time of death
– More difficult, since visible
fracture healing not visible
for first several weeks
Clues for Identifying Perimortem
Fractures

• Fresh bone more flexible than dry bone: it


bends before it breaks
• Radiating fractures around point of impact
• Adherent fragments in depressed fractures
• Spiral fractures of long bones: typical of
fresh bone
• Archaeological Context
Perimortem Skull Fracture

Suture
Separation

Radiating Fractures
Adherent bone fragments in perimortem fracture
Perimortem Spiral Fractures in Human Long Bones
Identifying Perimortem Injuries: Archaeological Context

Mass Burial of Sacrificial Victims


Identifying Perimortem
Injuries: Unusual
Position of Bones

Case Study:
The man with the
broken leg
Fracture of Femoral Shaft
Femoral shaft and neck
fracture
Fractures of Spinous and Transverse Processes of Vertebrae

Q: What kind of fractures are these?


Death by Violence?

Or by Accident?
Interpreting the Cause and
Significance of Fractures

Evidence of Violence
• Depressed fractures
of skull that match
known weapons
• Imbedded Projectiles
in Bone
• Parry Fractures
Occupational Hazards, Lifestyle

• Fractures commonly resulting from falls


and other accidents
– Colles’ Fracture
– Ankle, Collarbone, Ribs
– Ancient Nubia/Industrial England Comparison
Case Study
Case Study in Trauma
in Trauma Analysis:
Analysis:
TheThe
Pacatnamu Mass
Pacatnamú Mass Burial
Burial

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