A 14th–17th century osteoporotic hip fracture from the Santa Clara‐a‐Velha Convent in Coimbra (Portugal)

Abstract

Osteoporosis is an evocative term for a metabolic disorder characterized by loss of bone mass and organization, which predisposes to fracture. The clinical consequences of osteoporosis lie in the problems associated with it, specifically hip, Colles and vertebral fractures. We present here an extracapsular fracture of the proximal femur in an aged female skeleton from the Santa Clara-a-Velha Monastery (14th-17th centuries) in Coimbra, Portugal. This fracture is probably secondary to an osteoporotic disorder. Bone remodeling at the fracture site confirms that this woman survived for a long period after sustaining a fracture of the proximal femur, suggestive of a solid community assistance and support.

Hip fractures in the Portuguese archaeological record

“…Notwithstanding, there are increasing numbers of palaeopathological reports that refer to this type of fracture (e.g. Stroud and Kemp, 1993;Roberts and Manchester, 1995;Dequeker et al, 1997;Bartonícek and Vlcek, 2001;Campillo, 2001;Ibáñez, 2001;Mays, 2006;Ives, 2007;Salter-Pedersen, 2007;Curate et al, 2010).…”

“…The few existing palaeopathological studies which documented hip fractures convey a true prevalence ranging from 0.6% (Ives, 2007) to 2.0% (Curate, 2009), and a crude prevalence ranging from 1.4% (Curate et al, 2010) to 6.3% (Mays, 2006). Intermediary values were reported by Curate et al (2010), for the true prevalence (Table 1); and Mensforth and Latimer (1989) and Curate (2009), for the crude prevalence (Table 2). Therefore, the crude prevalence rates found in the different samples in the present study are usually lower than the ones reported in the available literature.…”

“…Previous studies by Ferreira and Silva (2002), Garcia (2007), Curate (2009), andCurate et al (2010) confirmed the existence of hip fractures in Portuguese skeletal material since at least the 11th century, but had a limited scope of analysis, both geographically and chronologically. This study aims to collect original information on hip fractures in the Portuguese archaeological record through a careful revision of several previously unpublished palaeodemographic and palaeopathological reports and to challenge the common perception that hip fractures, related or not with bone loss, were nearly absent in past populations.…”

“…A few years ago, Brickley (2002) stated that there were only two published cases of hip fracture in archaeologically derived bone, one from Roman Britain (Roberts and Manchester, 1995) and another from 12th dynasty Egypt (Dequeker et al, 1997), but evidence of fracture of the proximal femur in the archaeological record is growing (e.g. Stroud and Kemp, 1993;Bartonícek and Vlcek, 2001;Campillo, 2001;Ibáñez, 2001;Ferreira and Silva, 2002;Mays, 2006;Buzon and Richman, 2007;Salter-Pedersen, 2007;Ives, 2007;Curate et al, 2010). These studies imply that this was undeniably an existing condition in past populations.…”

Metacarpal cortical bone loss and osteoporotic fractures in the Coimbra Identified Skeletal Collection

“…Notwithstanding, a substantial number of vertebral compression fractures in men was observed in younger individuals and probably were not fragility fractures. In archeological contexts, fragility fractures of any type are usually associated with older individuals (Curate, Assis, Lopes, & Silva, ; Curate, Lopes, & Cunha, ; Ives, Mant, de la Cova, & Brickley, ; Lovell, ; Mays, ; Umbelino et al, ).…”