Trauma and treatment in the British Isles in the Historic Period • 229 



DISTRIBUTION OF 

 CEMETERY SITES 

 EXAMINED 



Figure I. Distribution ofcemetery sites examined. Note that 

 some areas represent more than one site. 



Burial conditions obviously determined how complete the 

 collections were. On some sites the soil pH was so low that 

 much of the skeleton was eroded and some bones were not 

 present for examination. This, among other factors, deter- 

 mined the number of traumatic features observed. 



CLINICAL DATA 



The study of trauma in past populations is, of necessity, 

 linked to diagnostic criteria in modem populations. For- 

 tunately, in contrast to ancient studies of populations, mod- 

 em studies of trauma are abundant in the literature. However, 

 clinicians have far more data to study including, in many 

 cases, a cooperative and talkative patient and clinical notes 

 on which to base diagnosis and treatment. The clinician also 

 has modem diagnostic t(X)ls and continuing development of 

 new methods and drug therapy to aid treatment. 



In ancient populations the researcher is limited to a study, 

 with whatever means available, of the dry bone evidence for 

 trauma and treatment. Use of only one source of evidence for 



Zagreb Paleiipalholofiy S\mp t9ftS 



reconstructing particular aspects of society has many inher- 

 ent limitations, not least a biased picture. 



The use of modem clinical data provides the opportunity to 

 interpret the ancient material with a greater degree of accura- 

 cy than would otherwise be possible without it. Modem trau- 

 ma studies appear in five fomis: { 1 ) papers on fracture pat- 

 tems in populations, e.g., Fife and Barancik 1985; (2) 

 fractures of specific bones, e.g., Einarsson 1958; (3) frac- 

 tures in specific age groups, e.g., children, Sharrard 1979; 

 (4) complete chapters in clinical textbooks e.g. Watson- Jones 

 1976; (5) specific features of fractures, e.g., Watson-Jones 

 and Coltart 1982. 



Studies of fracture pattems in modem populations are in- 

 valuable for workers in the field of paleopathology. This is 

 particularly relevant for the subject of etiology. The different 

 types of fractures observed in modem populations are usually 

 correlated with specific forces acting on the bone. For exam- 

 ple, an oblique fracture is usually caused by an indirect force. 

 In some cases an occupational causation may be postulated 

 (see Merbs 1983). 



Modem studies of fractures of specific bones are usually 

 concemed with incidence, causes (by age and sex), healing 

 and treatment, which are all subject areas comparable to 

 ancient skeletal material. Particularly relevant is the com- 

 parison of treatment and healing between ancient and modem 

 populations; were ancient populations producing good re- 

 sults from their fracture treatments when compared to mod- 

 em healing and treatment? 



The modem literature abounds with information on types 

 of fracture (cranial and postcranial), causes, healing, treat- 

 ment and complications. Reference to this data is essential to 

 the understanding of ancient trauma and treatment. 



However, despite being invaluable, modem clinical data 

 has some limitations. Forces producing fractures have re- 

 mained the same but their actual mode of production has 

 altered with changing technology. The literature is filled with 

 data on fractures caused by high-impact traffic accidents and 

 those caused by other modem technology. These data are not 

 relevant to the paleopathology of trauma. Data on healing of 

 modem fractures are influenced by modem drug therapy, 

 particularly antibiotics, and by modem methods of fracture 

 management such as plates, pins, screws, and bone grafts. 



The age at which the fracture occurred and the sex of the 

 patient are known in modem cases of fracture. In paleo- 

 pathology these details arc often not definitely detemiinable. 

 The age at which the fracture occurred is problematical but 

 would indeed have had an effect on fracture healing. Many 

 other factors must be borne in mind when interpreting the 

 healing of palcopathological fractures using modern data. 

 Environment, hygiene, living conditions and diet in the de- 

 veloped world should be beneficial for efficient healing and 

 should therefore influence healing times and the propensity 

 to infection. In addition, blood vessel and nerve injuries 

 associated with fractures in the palcopathological evidence 

 would have significantly affected how quickly a fracture 



