232 • Charlotte Roberts 



identification and interpretation of environmental evidence 

 such as seeds, insects and animal bones has helped to extend 

 archeological interpretation beyond the pottery stage. Re- 

 searchers no longer end their studies at "what kind of pottery 

 did they have" but can deduce "how people lived." Environ- 

 mental archeology "enables archeologists to move away 

 from examining the sterile remnants of ancient lives and 

 envisage the communities as they actually lived" (Shackley 

 1985:13). Studying one piece of evidence is no longer ac- 

 cepted as the sole basis for archeological research. 



The study of archeological data in association with the 

 paleopathological evidence is essential for an understanding 

 of the treatment and healing of fractures. Environment, in all 

 its facets, and hygiene will affect how well and quickly a 

 fracture heals. 



In Britain, in general terms, archeological data is in abun- 

 dance but there is often a bias in favor of particular periods of 

 time (often merely because of the abundance of evidence 

 available and of archeologists to deal with it) or regions of 

 Britain. There is especially a tendency in environmental 

 studies to produce detailed syntheses on the environmental 

 conditions of one structure (see Kenward et al. 1986; Grieg 

 1981 ). These studies are inevitable but useful. Disregarding 

 financial constraints, however, these analyses are very labor- 

 consuming. It will be some years before more regional stud- 

 ies of environmental archeology will be available for use in 

 such archeological research as paleopathology. In the case of 

 environmental archeology at York, the process of analyzing 

 organic remains is ongoing in order to extend knowledge of 

 the archaic environment of York. 



The study of trauma and treatment in antiquity has by 

 necessity generated many avenues of research to follow. One 

 must consult many areas of evidence to gain an accurate 

 picture of how well cranial and postcranial fractures were 

 treated and how well they healed. This research encompasses 

 the skeletal evidence of fractures and the therapeutic mea- 

 sures of reduction, splinting and trepanation. But it also 

 covers many other subject areas: concepts of disease and 

 treatment, anesthesia, diagnostic procedures, anatomical 

 knowledge, dressings, surgical instruments and herbal reme- 

 dies, blood letting and hemostasis, complications of frac- 

 tures, hospitals and personnel. The Roman to late and post- 

 Medieval [periods were interesting eras and the wealth of 

 evidence spanning 1600 years will provide abundant data for 

 this research. 



Observational methods 



RECORDING OF LONG BONE AND SKULL FRACTURES: 

 MACROSCOPIC 



Consultation of modem clinical data on fractures was neces- 

 sary to compile a recording form adequate to describe the 



nature of the fracture with reference to modem accounts of 

 fractures. Recording forms were developed for both long 

 bone and skull fractures. 



Cemetery site, period of time (Roman, Anglo-Saxon and 

 Medieval), location of bone, age and sex were recorded as 

 basic data. The bone or anatomical part affected and side of 

 body were noted so that quick reference could be made. 

 Fracture position on long bones was recorded in terms of 

 proximal, mid or distal third of the bone shaft. Fractures 

 occurting proximally or distally to these three levels were 

 described with reference to anatomical points on the bone 

 (Warwick and Williams 1973). The level of fracture on the 

 bone has important implications for particular neural and 

 vascular complications; for example, healing of a fracture to 

 the distal third of a tibia may be delayed due to a disruption in 

 the blood supply to the distal fragment and a fracture to the 

 midshaft of the humems may lead to radial nerve palsy. The 

 radial nerve is close to the bone at this point and is therefore 

 very vulnerable (Klenerman 1966). The effect of continuous 

 radial nerve palsy would be paralysis of the extensor muscles 

 of the wrist, thumb and fingers causing wrist drop. 



The type of fracture an individual sustains will give an 

 indication of the type of force acting on the bone to produce 

 the break. This feature can have implications for 



(1) interpreting occupation (e.g., Merbs 1983), warfare 

 (e.g., Manchester and Elmhirst 1980), or domestic acci- 

 dents; 



(2) determining how quickly the fracture healed. For ex- 

 ample, oblique or spiral fractures are more stable than trans- 

 verse fractures. In addition, some types of fractures are, in 

 modem populations, correlated with particular types of 

 accidents — a Colles fracture of the distal end of the radius, 

 for example, which occurs when a person, particularly an 

 elderly woman with osteoporosis, falls on an outstretched 

 hand; 



(3) identifying potential complications of injuries to the 

 skull; for example, a blade injury and depressed fracture 

 produce different types of brain injury. Different areas of the 

 skull produce contrasting complications. 



To record healing of the fracture, a general assessment was 

 made of how well the bone had healed, taking into account 

 many different features identifiable at the fracture site: 



SHORTENING. By Comparison with the opposite leg or arm, 

 the degree of loss of length was assessed (Figure 2). This 

 gave an indication of how well or how badly the fracture was 

 reduced and/or splinted in the right position. 



INFECTION . Evidence of an infective process was defined by 

 new bone growth and/or pitting of the bone surface around 

 the fractured site with or without an associated osteomyelitic 

 lesion displayed as a sinus on the bone surface (Figure 3). 

 Presence or absence of infection gives an indication of the 



Zafireb Paleopathology Symp. 1988 



