Caring for the injured: Exploring the immediate and long-term consequences of injury in medieval Cambridge, England

IF 1.3 3区 地球科学 Q3 PALEONTOLOGY
Jenna M. Dittmar , Bram Mulder , Anna Tran , Piers D. Mitchell , Peter D. Jones , Sarah A. Inskip , Craig Cessford , John E. Robb
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引用次数: 1

Abstract

Objective

To combine paleopathological and biomechanical analysis to reconstruct the impact that a severe skeletal injury had on an individual’s ability to function and participate in medieval society.

Materials

Three medieval individuals from Cambridge, England with ante-mortem fractures to the lower limb were analyzed.

Methods

Plain X-rays were used to determine the degree of malunion, rotation and overlap of each fracture. Cortical bone architecture of the injured individuals and 28 uninjured controls were analyzed using micro-computed tomography (µCT). Clinical and functional consequences were examined using the Bioarcheology of Care framework.

Results

The mechanism of injury, the secondary complications, and the extent of the care received was reconstructed for each individual. Bilateral asymmetry in the cortical bone architecture revealed the long-term alterations to each individual’s gait.

Conclusion

Each of these individuals survived a severe injury resulting in chronic physical impairment, though not all would have been considered ‘disabled’.

Significance

This research contributes to the discussion about medieval care provision and social constructions of disability by illustrating how an interdisciplinary approach provides insight into the experiences of those with physical impairments. The integration of µCT imaging within the Bioarcheology of Care model is a novel approach with great potential for application across the field.

Limitations

Biomechanical analysis was restricted to cortical geometry.

Suggestions for future research

Further study of bilateral asymmetry in trabecular architecture could complement our understanding of altered loading modalities in past societies.

照顾伤者:探索中世纪英国剑桥受伤的即时和长期后果
目的结合古病理学和生物力学分析,重建严重骨骼损伤对个体功能和参与中世纪社会的影响。研究人员分析了来自英国剑桥的三名中世纪人,他们死前下肢骨折。方法采用x线平片测定骨折的畸形愈合、旋转和重叠程度。使用微计算机断层扫描(µCT)分析受伤个体和28名未受伤对照的皮质骨结构。使用护理的生物考古学框架检查临床和功能后果。结果对每个患者的损伤机制、继发并发症和护理程度进行了重建。双侧皮质骨结构的不对称揭示了每个人步态的长期改变。尽管并非所有人都被认为是“残疾”,但这些人都在严重伤害导致的慢性身体损伤中幸存下来。本研究通过说明跨学科方法如何提供对身体缺陷者经历的洞察,有助于讨论中世纪的护理提供和残疾的社会结构。将微CT成像集成到生物考古模型中是一种具有巨大应用潜力的新方法。局限性:生物力学分析仅限于皮质几何。对未来研究的建议进一步研究小梁结构的双侧不对称可以补充我们对过去社会中改变的负荷方式的理解。
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来源期刊
CiteScore
2.90
自引率
25.00%
发文量
43
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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