Trauma in the Crusader period city of Caesarea: a major port in the medieval eastern Mediterranean

Abstract

Caesarea is the first fortified city to undergo palaeopathological analysis of its Crusader period inhabitants. This study of the 12th and 13th century population aims to determine the major types of trauma present, whether from weapon injuries or accidents. Since the Crusades were known for the significant number of battles and raids that took place, weapon injuries were expected to be common. Thirteen cases of trauma are described and a highly unexpected pattern has come to light. These cases do not include one single example of weapon-related trauma. Every fracture is of a type expected from accidents or interpersonal violence without weapons. Possible explanations include the location of the city deep within Frankish territory and the robust city walls giving effective protection to the inhabitants, and also that the population were involved in activities that left them prone to accidents but not weapon injuries. The other important finding from this study was that the cases of lower limb long bone spiral fractures had healed in a near-anatomical alignment. This is not what we would expect, as a proportion of these injuries would normally have been unstable and tend to heal poorly aligned. The good position could have resulted from surgeons' use of splints to immobilise the bones while they healed. This suggestion is supported by laws of the kingdom of Jerusalem, which stated that surgeons were to be punished if they allowed such fractures to heal at an angle.

The Osteological Paradox 20 Years Later: Past Perspectives, Future Directions

“…We identified several articles that use a sample of short duration (less than 30 years or about one generation). The majority of these papers analyze historical collections (Assis et al 2011;Capasso 2007;Crist and Sorg 2014;Palubeckait_ e et al 2006) or collections associated with historically significant events (Geber and Murphy 2012;Mitchell 2006), which define the short duration of use. Several adopt a forensics perspective on trauma analysis using modern or near-modern collections (Nagaoka 2012;Steyn et al 2010;van der Merwe et al 2010).…”

Hip fractures in the Portuguese archaeological record

“…Lovejoy and Heiple, 1981;Grauer and Roberts, 1996;Lovell, 1997;Judd and Roberts, 1998;Alvrus, 1999;Jurmain, 1999;Neves et al, 1999;Domett and Tayles, 2006;Djuric et al, 2006;Mitchell, 2006) but the majority of them are the result of a traumatic episode and do not reflect any frailty intrinsic to the bone itself (Dequeker et al, 1997). Fragility fractures, specifically hip fractures, are regarded as unusual occurrences in archaeological skeletal material (Ortner, 2003;Agarwal et al, 2004).…”

Trauma

“…Lovejoy and Heiple (1981) tackled this issue and included only complete long bones and crania in their fracture analysis of Ohio's Libben people. Similar approaches to trauma analysis have provided insight into a diverse range of social issues and the consequences of technological developments, such as power struggles (Andrushko et al 2005), military strategies (Šlaus et al 2010), ecological decline (Walker 1989;Torres-Rouff and Junqueira 2006), fertility rituals (Conlee 2007), peaceful and volatile imperial administrations (Buzon and Richman 2007;Erfan et al 2009), hazardous occupations (Djuric´ et al 2006; Van der Merwe et al 2010), subsistence change (Domett and Tayles 2006), architectural sophistication (Kilgore et al 1997) and surgical skill (Mitchell 2006;Redfern 2010). Lovejoy and Heiple's (1981) systematic fracture recording integrated with comparative clinical studies advocated by Jones's (1910) and the epidemiological approach of Hooton (1930) advanced our ability to more confidently assess injury patterns and treatment within a society, between contemporary communities and over time.…”