{"title":"Surgery under siege: A case study of leg amputation in 18th century Louisbourg, Nova Scotia, Canada","authors":"N. Hughes , A.B Scott , D. Pitcher","doi":"10.1016/j.ijpp.2024.01.002","DOIUrl":null,"url":null,"abstract":"<div><h3>Objective</h3><p>Paleopathological analysis of a below-knee amputation was conducted to explore the sociocultural reasons why the amputation took place.</p></div><div><h3>Materials</h3><p>Older adolescent male (18–21 years) from the New Englander mass burial at the 18th century Fortress of Louisbourg.</p></div><div><h3>Methods</h3><p>Macroscopic assessment and archival data.</p></div><div><h3>Results</h3><p>A surgical amputation of the right tibia and fibula, distal to the knee was identified. The cross-sectional diaphysis of the leg has kerf marks and a splinter (breakaway point) at the posterior-lateral border of the tibia suggesting the leg gave way from its own weight or was manually removed once most of the sawing was complete.</p></div><div><h3>Conclusions</h3><p>Archival records suggest frostbite from prolonged exposure to freezing temperatures and trauma from unsafe working conditions at the Fortress were the main causes that led to amputation.</p></div><div><h3>Significance</h3><p>This case study highlights the importance of contextualizing cases of amputation to understand factors leading to the amputation procedure and techniques used in the past, and the social and living conditions of the individual.</p></div><div><h3>Limitations</h3><p>Observations were restricted to skeletal material as soft tissue decomposed and there was no material evidence suggestive of amputation associated with this individual in their grave.</p></div><div><h3>Suggestions for future research</h3><p>Full trauma assessment of the Fortress of Louisbourg skeletal collection to provide additional insight into injury sustained at Louisbourg and 18th century surgical practices.</p></div>","PeriodicalId":48817,"journal":{"name":"International Journal of Paleopathology","volume":"44 ","pages":"Pages 112-118"},"PeriodicalIF":1.3000,"publicationDate":"2024-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1879981724000020/pdfft?md5=dc8c699940d58945d6f674e3c3ecef95&pid=1-s2.0-S1879981724000020-main.pdf","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"International Journal of Paleopathology","FirstCategoryId":"89","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S1879981724000020","RegionNum":3,"RegionCategory":"地球科学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"PALEONTOLOGY","Score":null,"Total":0}
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Abstract
Objective
Paleopathological analysis of a below-knee amputation was conducted to explore the sociocultural reasons why the amputation took place.
Materials
Older adolescent male (18–21 years) from the New Englander mass burial at the 18th century Fortress of Louisbourg.
Methods
Macroscopic assessment and archival data.
Results
A surgical amputation of the right tibia and fibula, distal to the knee was identified. The cross-sectional diaphysis of the leg has kerf marks and a splinter (breakaway point) at the posterior-lateral border of the tibia suggesting the leg gave way from its own weight or was manually removed once most of the sawing was complete.
Conclusions
Archival records suggest frostbite from prolonged exposure to freezing temperatures and trauma from unsafe working conditions at the Fortress were the main causes that led to amputation.
Significance
This case study highlights the importance of contextualizing cases of amputation to understand factors leading to the amputation procedure and techniques used in the past, and the social and living conditions of the individual.
Limitations
Observations were restricted to skeletal material as soft tissue decomposed and there was no material evidence suggestive of amputation associated with this individual in their grave.
Suggestions for future research
Full trauma assessment of the Fortress of Louisbourg skeletal collection to provide additional insight into injury sustained at Louisbourg and 18th century surgical practices.
期刊介绍：
Paleopathology is the study and application of methods and techniques for investigating diseases and related conditions from skeletal and soft tissue remains. The International Journal of Paleopathology (IJPP) will publish original and significant articles on human and animal (including hominids) disease, based upon the study of physical remains, including osseous, dental, and preserved soft tissues at a range of methodological levels, from direct observation to molecular, chemical, histological and radiographic analysis. Discussion of ways in which these methods can be applied to the reconstruction of health, disease and life histories in the past is central to the discipline, so the journal would also encourage papers covering interpretive and theoretical issues, and those that place the study of disease at the centre of a bioarchaeological or biocultural approach. Papers dealing with historical evidence relating to disease in the past (rather than history of medicine) will also be published. The journal will also accept significant studies that applied previously developed techniques to new materials, setting the research in the context of current debates on past human and animal health.
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