246 • Robert D. Jurmain 



Figure 7. Left and right innominate 

 bones, showing hypertrophy of left 

 acetabulum. Female, adult. 



The final two cases of projectile wounds both involve the 

 innominate. A young adult male (18-25 years) exhibits a 

 through-and-through lesion of the left ilium 30 mm below the 

 iliac crest on the ventral surface, 40 mm lateral to the sacro- 

 iliac articulation. 



Evaluation of the bone immediately adjacent to the point 

 was inhibited by the presence of adhesive that had previously 

 been applied to hold the point in place. Nevertheless, evi- 

 dence of reparative processes is not evident. In fact, it would 

 have been unlikely this individual would have long survived 

 such a wound. The angle of trajectory (from the front) sug- 

 gests the projectile penetrated the descending colon, small 

 intestine, and intrapelvic vessels, most probably resulting in 

 rapid death. 



The last individual with clear evidence of a projectile 

 wound is an adult of indeterminate sex — a very fragmentary 

 burial that was mostly cremated. Here, an obsidian projectile 

 fragment was found in the right ilium approximately 20 mm 

 below the crest and 100 mm anterolateral to the auricular 

 facet. The probable trajectory was anterolateral in relation to 

 the pelvis and may have penetrated the ascending colon caus- 

 ing intra-abdominal infection. In any case, no evidence of 

 healing is seen on gross examination, on magnification, or on 

 x-ray. 



The final class of trauma of note that is diagnostic in this 

 population is dislocation. Such lesions do not usually leave 

 their traces on bone frequently enough to approach them 

 epidemiologically. Still, they are of interest, especially the 

 differential diagnosis of traumatic dislocation from congeni- 

 tal problems. In this population a good example of each is 

 seen in the hip. The first example, a probable dislocation, is 

 in an adult female and displays considerable remodeling 

 about the left acetabulum, as though the joint capsule had 

 been ruptured (Figure 7 ). The femur head is preserved as only 

 a fragment, but still shows the typical hypertrophic appear- 

 ance of the "mushroom-head." In addition, the lesser 

 trochanter is remodeled, possibly indicating a pulled tendon. 



The second case, a female 21-30 years old, has a de- 

 formed right acetabulum. The rim is not completely devel- 

 oped, and there is a small nearthrosis infero laterally. The 



femoral head is flattened interiorly and extended dor- 

 solaterally (fitting the nearthrosis on the innominate) (Figure 

 8). Moreover, the entire right femur appears deformed, is 

 narrower (maximum diaphyseal diameter immediately be- 

 low lesser trochanter: R = 27.5 mm, L = 33.2 mm) than the 

 left and is twisted approximately 90° along the entire proxi- 

 mal two-thirds of its shaft. In all respects this appears as a 

 very good example of a congenital malformation in both the 

 acetabulum and femur resulting in chronic dislocation of 

 the hip. 



A third case of hip dislocation is also of interest. In this 

 case (a male more than 30 years of age) the femur head is 

 flattened and partly mushroomed. Likewise, the acetabulum 

 is greatly hypertrophied and expanded. While no permanent 

 disruption of the joint or nearthrosis is evident, a probable 

 etiology is suggested by other bony changes. On the femur a 

 slight myositis ossificans is seen (medially 47 mm below the 

 lesser trochanter), suggesting a muscle injury of the superior 

 portion of vastus internus. In addition, the anterior, inferior 

 iliac spine is moderately hypertrophic (suggesting a further 

 traumatic injury of rectus femoris). Thus, while this case may 

 not present the classic picture of a major dislocation, a severe 

 traumatic incident followed by secondary degenerative joint 

 disease is suggested. 



Conclusions 



While the incidence of trauma resulting from accidents is low 

 in this population, the evidence of interpersonal violence is 

 unusually common. Most healed fractures that were found 

 are in the forearm, and a high proportion of these may have 

 resulted from parrying blows. In addition, the unambiguous 

 evidence often embedded projectiles (in nine different indi- 

 viduals plus a probable healed wound from a projectile in 

 another individual) is of remarkably high incidence in this 

 population. 



In other North American populations a comparable, high 

 incidence of projectile wounds has not been reported from 

 any single site. For example, at Libben, which includes more 

 than 1300 individuals, no projectile wounds were detected. 



Zagreb Paleopathology Symp. l9Hf< 



