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  • Dale Munn

What are the Skeletal markers of sharp and blunt force trauma?






Figure 1: Fracture types caused by direct trauma where the bone is the first point of impact. From left to right: transverse, penetrating, comminuted and crush (Lovel, 1997 p142).




Figure 2: Fracture types caused by indirect trauma where the bone is not the first point of impact from left to right: oblique, spiral, greenstick due to angular force, greenstick due to compression, impaction and avulsion (Lovel, 1997 p143).



1.1 Accidental and Intentional injuries


Wherever possible distinction must be made between intentional blunt force trauma such as a club, hammer, fist, kick, and accidental trauma caused by for example, falls or collision with heavy moving objects such as farm animals or carts. Novak and Slaus, (2012) studied a 13th to 16th century Croation cemetery population and identified direct transverse fractures to the distal radius as the most common fracture which often results from a fall when the arm is extended to break the fall (Figure 1 ). Indirect transverse fractures of the clavicle, particularly at the sternal end can also result from falls onto an outstretched hand particularly where the arm is positioned to the side at impact (Figure 2) (Chadwick and Kyle 1992; Robinson, 1988). Fractures of the first metacarpal largely involve the proximal end (Bennett’s fracture) which are characteristic of a fall onto an outstretched hand with the thumb absorbing most of the impact (Sandzén, 1979).


Novak and Slaus (2012) also point to fractured tibiae being more likely to be the result of falls with indirect oblique and spiral mid shaft fractures and fractures of the proximal and distal epiphyses predominating (Figure 2). They also identified this type of accidental trauma predominating in males who may have performed more physically demanding and risky tasks involving heavy farm animals together with strenuous physical work in difficult terrain.

Rib fractures are also common in falls and are likely to be oblique fractures (Figure 1) which usually occur on the lateral curvature of the ribs (Galloway, 1999). Individuals landing on their feet are more likely to suffer fractures of the pelvis and spine if the distance is over 10.5m, (McNulty, 2016). Falls from significant height and collision with heavy moving objects such as farm animals and carts also cause fractures to the os coxae (Reber and Simmons, 2015). However, as Brink et al. (1998) have shown, injuries from falls can also be an injury mechanism for deliberate assault where the victim was pushed and fell from a height. Compressive forces can result in depressed or crushing injuries; sometimes seen in the vertebrae and ribs. (Kimmerle and Baraybar, 2008).


Distinguishing between accidental and deliberate fractures to the skull in archaeological examples is extremely difficult. Guyomarc’h et al. (2010) studied an interpretation of the Hat Brim Line (HBL) theory (Figure 3 p11) by Kremer et al.(2008) According to this rule, an injury at the level where the brim of a hat would lie is more likely the result of a fall, while a deliberate blow would be more likely to produce a wound above this line.

Guyomarc’h et al. (2010) used autopsy cases from Montreal, Canada from 2000 to 2005. A total of 113 cases were studied: 29 cases of falls from one’s own height, 21 cases of falls downstairs, and 63 cases of homicidal blows. They revised the HBL criteria for deliberate blows to include comminuted, (where there are more than two bone fragments produced by an injury (Figure 1) or depressed calvarial fractures located above the HBL located on the side of the skull together with possible facial fractures. 82% of falls and 93.7% of blows were diagnosed correctly using these criteria. Guyomarc’h et al. (2010, p127). They also, however included the presence of lacerations as criteria which would no longer survive in archaeological examples (Guyomarc’h et al. 2010, p127)

Hussain et al. (1994), noted that cranial vault fractures resulting from broad impacts to the skull are often caused by accidental injury such as falls and hitting the head on the ground or an object and tend to be linear and radial rather than comminuted and depressed which is characteristic of a deliberate blow.



Figure 3: The hat brim line (HBL) , (Guyomarc’h et al. 2010, p424)



1.2 Sharp Force Trauma to the Cranium


Injuries produced by a bladed weapon are classed as sharp force trauma (SFT). Wenham (1989, p137) has shown that fighting methods using swords involved mainly obliquely directed downward blows onto the head and possibly shoulder and arms with occasional thrusting movements. If the attacker was right-handed, then the blows to the head would likely be to the left side of the frontal and parietal bones suggesting that the attacker and their opponent were facing each other. Only four out of 15 cranial injuries from the seventh century cemetery at Eccles, Kent were to the right side of the skull (Wenham, 1989 p138). In the early medieval period in England the edged weapons which could have inflicted sharp force injuries were swords, the seax (long bladed knife), knives and spears (Wenham, 1989, p139).


Blows to the occipital bone or the posterior part of the parietal bone or the right side of the cranium are likely to be aimed at a fleeing victim, one who has fallen down, been attacked from behind, or delivered by a left-handed attacker (Wenham, 1989 p138). Horizontal blows were very rare. In skulls possessing several cuts with variable direction, this was usually evidence that the victim had fallen to the ground after the first blow (Wenham, 1989 p137). Many fatal cranial injuries consist only of a single blow with Injuries penetrating the meninges and the brain leading to death soon afterwards from shock, damage to the central nervous system and blood loss (Wenham, 1989 p128).Wenham (1989 p132) also states that injury lengths must be shorter than the blade length unless the blade slices rather than chops. The blade injuries from the Eccles cemetery vary between 12 and 16cm in length suggesting a chopping rather than slicing action (Brødholt and Holk, 2012, p211).


Ingelmark (1939 p181) studied 1185, skeletons from the battle of Visby in Gotland, Sweden in 1361. He found that 53% of cranial wounds were to the left side of the skull and 32% to the right. 39% of skulls showed evidence of two or more cuts and 46% had just one cut to the skull He also suggested that two or more cuts represented injuries to individuals who were struck on the ground. The 14% of wounds to the occipital bone were seen as indicative of an individual running away or struck whilst on the ground. 74.4% of cranial wounds were delivered obliquely from above of which 61.7% involved only one blow suggested that single blows were also a sign of warriors standing face to face (Ingelmark, 1939 p183).

Where individuals had suffered multiple blows to the skull and particularly those delivered from the side was interpreted as evidence that the victim was on the ground as multiple blows would be difficult to administer to an upright individual on the move who would collapse after the first blow (Ingelmark, 1939 p183).





Figure 4: Cross section of an edged penetrating weapon injury (Wenham, 1989, p130).


SFT wounds can be linear or irregular shape, with sharp edges, smooth, flat and/ or polished surfaces and can be V or U-shaped in cross section (Brødholt and Holck, 2012) (Figure 4 and figure 5). Flakes of damaged surface bone can often be found in the wall opposite the smooth contour If the blade entered the wound at right-angles when both walls are likely to be smooth. Any variation on a right angle leads to only one side being smooth (Brødholt and Holck, 2012) (Figure 5).


Strikes by heavy bladed weapons such as swords and axes may also display aspects of blunt force trauma (BFT), such as chunks of bone pushed into the brain (Alunni-Perret et al. 2005). The extent of the damage will depend on the force applied, position of the body at the time of impact, angle and frequency of strikes, thickness of the bone, and the presence or not of soft tissue or clothing. The width and depth of injuries is also dependent on blade size (Lewis, 2009).




Figure 5: 78.6 mm x 27.3 mm sword cut to left parietal bone. The superior edge of the cut (A) is characterized by a smooth surface, whereas the inferior (B) is irregular caused by the detachment of the cranial vault fragment (Valoriani et al. 2017, p112).













Figure 6: Peri-mortem SFT to the face










Figure 7: Knife cuts with plain edges (Norman et (Novak, 2014 p101) al. 2018, p167).
















Figure 8: SFT to posterior distal radius (Valoriani, 2017, p1)


In general knives and seaxes are used with one hand and have straight rather than serrated edges (Wenham, 1989 p139). Knife marks can be narrow and deep depending on the nature of the blade with little damage to the sides of the cut and can have a meandering floor due to the lateral motion caused by stabbing or cutting. Sharp bladed incisions were deep, smooth and steeply sided, within an apex that had a sharp point or a horizontal platform with a V-shaped profile, depending on the angle of the cut. Blunt or dulled knives often created a flat-bottomed P-shaped profile. (Lewis, 2008; Greenfield, 1999).


1.3: Post Cranial Sharp Force Trauma


Wenham’s observations (1989),of six victims of cranial sword injuries from the early Anglo-Saxon site of Eccles in Kent. suggest that sharp force trauma morphology is consistent across cranial and post cranial elements, (Figure 8).

Geber(2012) studied two sites with 218 individuals from early medieval Ireland. One late middle adult male had 127 sharp force trauma wounds (Figure 9 p14) including thrusts in an upwards motion through the abdomen towards the diaphragm indicated by cut marks to the left side of the lumbar vertebrae. These wounds were a combination of stabs and slashes and may have been inflicted by a spear or a knife (Geber, 2012).





Figure 9: Overall location of possible spear/knife stab wounds and slashes(a) wounds on the neck and proximal shaft of the right femur (b) and on the right pubic bone: medial (c) and posterior view (d). (Geber, 2012, p261)







Figure 10: Cranial Internal bevelling in a concentric fracture (Hart, 2005, p4)



The cut on the forearm of a medieval victim from Gloucester in figure 8 was situated on the posterior surface of the distal end of the left radius. One inner wall of the cut mark is smooth, whereas the outer is irregular because of a detachment of bone flakes. The section is V-shaped the direction of the cut and its location suggest a defensive wound (Valoriani, 2017).

Ingelmark (1939, p167) also noted a large number of lower limb injuries at the battle of Visby, particularly affecting the tibia (65% of all lower limb injuries with femur 14.3% and fibula 19.3%).There were 185 cuts to tibiae, 54 to the fibulae, 40 to the femur and 49 to arms (Ingelmark,1939 p171). He suggested that these represented areas of the body unprotected by armour which would lead to immediate incapacitation with the final blows delivered when the victim had fallen to the ground. He also suggested that wounds could have been administered to warriors on horseback where the tibia was exposed, and the upper body would have been difficult to reach. Only two injuries were recorded to hand bones and very few to the feet. Both areas may have been offered some protection by shoes and gauntlets. The central part of the tibia received most cuts (65%, proximal 15%, distal 21%). 68% of cuts were aimed from above descending horizontally (Ingelmark 1939, p176).


Novak (2014) studied the injuries from 50 individuals found in a mass grave from the battle of Towton, 1461. She also observed that the skull was the most common target (43 post-cranial injuries compared to 113 cranial blows, The mandible too was a common site for wounds. However, many post-cranial wounds may have been soft tissue injuries and not marked the skeleton, only two thrust injuries were recorded to the post cranial skeleton (Novak 2014 p99).

She found that the majority of sharp and blunt force trauma wounds were delivered to the front and back of the skull with which she suggests are the result of blows delivered from above while the victim is on the ground: 32% to the occipital, 32% to the frontal, 31% to the left parietal, 24% to the left temporal (Novak, 2014 p96). 30% of the total number of cranial blows were also directed at the mandible.

28 out of 43 post cranial injuries to the upper body were the result of parrying repeated blows (Novak, 2014, p95). There are many similarities with the Visby victims (Ingelmark, 1939) where most wounds were also received when the individual was incapacitated and lying on the ground (Novak, 2014, p91).


1.4 Cranial Blunt Force Trauma





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Figure 11: Distribution of cranial BFT on Towton battle victims( Novak, 2014 p 95)








Figure 12: Peri-mortem multiple depressed







Figure 13: Healed BFT depressed fracture to the frontal bone (McNulty, 2015, p51). fractures to the frontal bone (McNulty 2015, p51),


Blunt force trauma injuries are produced by low velocity mechanical forces. Examples of blunt instruments might include fists, kicks, clubs, hammers and stones (Ambade, and Godbole, 2006). The extent of the skull fracture depends on the direction, force and time taken to produce it, as well as the size, shape and velocity of the weapon and whether the victim was stationary, on horseback or on foot and wearing protection or clothing (Leestma and Kirkpatrick, 1988).


Novak’s 2014 study of battle wounds at Towton found that in blunt force trauma injuries most were also directed at the left side of the skull and face (Figure 11).



Figure 14: Linear fractures initiating at point of impact (A-C) and away from the point of impact (D). (Isa, 2020, p54)



Figure 15: Fractures radiating from the impact site and concentric fracture (Hart, 2005, p2).


In interpersonal violence the head is often the main target and is the most vulnerable area when damaged (Passalaqua and Rainwater, 2015). The left or front of the skull is the most frequent injury site in face-to-face confrontations with a right-handed assailant (Jimenez-Brobeil et al.2009) ( Figures 11). Although far less frequent, blows delivered from behind lead mostly to injuries to the occipital bone and right-hand side of the cranium. Right side injuries may also indicate a left-handed assailant (Wenham, 1989 p131). Contre-coup fractures often result from force applied to the superior or posterior regions of the skull and typically result in reciprocal comminuted fractures of the thin bones of the eye orbits (Spitz et al, 1993).

A key indicator of deliberate blunt force injury to the skull is the ovoid, dish, saucer-like or elliptical shaped injuries that can reflect the shape of the weapon with the bone caving in away from the point of impact (Cybulski, 2013) (Figures 14). Narrow impacts may also result in depressed and potentially penetrating fractures (Galloway, 1999).


In a study of weapon related BFT in indigenous Canadian populations, Cybulski, (2013) describes funnel shaped lesions, the deepest often accompanied by inner table protuberances or bulges, characteristic of injuries caused by clubs. Injuries of a smaller size may be more indicative of projectile point injury. The average diameter in Cybulski’s study was 23mm. BFT to the skull of this type is often survivable if the blows are not powerful enough to penetrate the inner table of the cranial vault and damage the underlying brain and the meninges (Lambert, 2007).


Penetration of the bone also is likely to produce radiating fractures through thinner areas of bone Displacement inwards may also result in concentric fractures that surround the impact site (Figure 14). A plug of bone may also be displaced if enough force is applied (Kimmerle and Baraybar, 2008 ; McNulty, 2015). Concentric fractures extend from a point of impact. Radiating fractures extend away from a point of stress as a force dissipates across the bone (Kimmerle and Baraybar 2008) (Figure 15).


BFT to the cranium is also characterised by internal bevelling on the endocranium (Figure 11, p16), with the flaking off of the fracture margins on the endocranial surface (Berryman and Symes, 1998; Byers, 2011). Hart, (2005) in a modern American study of fatal blunt force trauma victims found that internal bevelling was present in 73 out of 79 cases of known BFT to the cranium.


The position of fracture lines may also indicate the impact point Blunt force injuries usually produce radiating fractures away from site of impact. However, Isa (2020) has also shown that in some cases impacts can also result in remote linear fractures (Figure 15).

The sequencing of injuries can also be determined using Puppe’s Rule that states that fracture lines from subsequent injuries will terminate in pre-existing fractures (Kimmerle and Baraybar, 2008). In BFT Sheridan and Nash (2007) also identified the frontal bone as a typical target in face-to-face fights and the occipital bone is often a wound site if an individual is knocked to the floor and a blow is struck to the back of the head.


1.5 Blunt force trauma to the post cranial skeleton

Transverse fractures to the middle or distal third of ulna could be caused by parrying a blow. Such fractures tend to be butterfly fractures where the bone fails first at the body of the butterfly then sheers towards the site of impact (Figure 16) (Knüsel and Smith, 2013). In the lower extremity, a butterfly fracture is more commonly seen than other areas of the body. This involves a triangular wedge of bone separating from the diaphysis (Galloway 1999).





Figure 16: Healed possible parry fracture of the left ulna. (Novak and Slaus, 2012, p340).


However, Novak (2009) using a modern study of fractures in 673 women admitted to Bradford Royal Infirmary disputes the description of parry fractures as indicative of defensive wounds and whilst trauma to the ulnae and radii is often located in or near the joints, these fractures were indistinguishable from accidental trauma resulting from falls. Not a single domestic assault from the sample produced a fracture that was recorded as the result of parrying a blow (Novak, 2009). Archaeological examples of fractures of the ulna should therefore be treated with caution unless they are accompanied by other contextual injuries.

Rib fractures are common in accidents but fractures from blows are usually transverse, oblique or butterfly fractures (Wedel, 2013). Fractures that involve the shaft (rather than the neck) of the rib are more likely to be the result of interpersonal violence (Love et al. 2012).

After the skull, the hand has been found to be the most frequently fractured bone in BFT with the fifth metacarpal bone being the most fractured bone (Gudmundsen and Borgen, 2008). In a modern study of 271 fractures of the fifth metacarpal, 121 male and nine females had fractures which occurred through fistfights or punching a hard object with the majority of fractures located in the neck of the metacarpal (Gudmundsen and Borgen, 2008). Cybulski (2013) also points to the fractures of the fourth metacarpal as indicative of interpersonal violence in males.




Figure 17: CT scan of transverse sternal fracture (Monaco and Lentini, 2009, p2)


Fractures of the scapular neck may also be a feature of BFT. These occur as a result of blows directed anteriorly, posteriorly, or directly onto the point of the shoulder (Neer, 1984). Such fractures are relatively uncommon, the body of the scapula is rarely injured due to protection by the overlying group of muscles (Pavlov and Freiberger, 1978).


Sternal fractures may also be a feature of violent assaults, particularly from repeated punching or stamping on the chest of a supine victim (Galloway, 1999). Such attacks often lead to transverse fractures (Figure 17) rather than vertical, longitudinal, or chipping and are most often seen in the midbody or manubrium, (Athanassiadi et al. 2002). The most common site is at the sternal angle (Collins, 2000). Collisions with heavy moving objects such as horses’ hooves or moving carts may also lead to sternal fractures.



Figure 18: Oblique mandibular fracture left side (Galloway et al .2013 p170).





Figure 19: Healed fractures to the right maxilla and nasal bone, Novak, (2009, p248)



Brink et al. (1998) studied a modern Danish collection of 1481 victims of interpersonal violence. Over 70% of both males and females had injuries to the head, neck or face, with the left side most affected. Most injuries were in soft tissue but 11.6% of these individuals had sustained fractures, the majority of which were observed in males and situated in the skull, nasal bones, dentition, mandibular and zygomatic bones. Mandibular fractures are often the result of anterior force applied to the chin or lateral force applied against the mandibular ramus. Vertical rather than horizontal fractures of the mandible are most likely in assaults (Cybulski, 2013) (Figure 18).


Walker (1997) found a 7% rate of nasal fractures in modern populations admitted to accident and emergency centres in the US, Europe, and Asia (106 out of 1506 individuals). In both sexes, most of the fractures, particularly to the nose and dentition, were produced by punches .The high number of nasal fractures in a recent study of 18th century Royal Naval skeletons is attributed to interpersonal fighting, such as would occur in brawls involving the distal part of the nasal bones, with depression and frequently deviation of the bony bridge from the midline (Boston, 2013) (Figure 19).


Although fractures of the clavicle are usually the result of falls against the shoulder or an outstretched hand, they can occasionally be a result of a direct blow, particularly the left clavicle (Robinson 1998; Stanley et al. 1988).

Hyoid fractures, although rarely observed in archaeological examples are usually associated with strangulation (Kimmerle and Baraybar 2008; Sheridan and Nash 2007).


1.6 Intimate Partner Violence and Interpersonal Violence


Redfern, (2015) has noted from a case study evaluating the injury patterns in 964 post-medieval adult females from London that the majority of injuries that conform to a model for Intimate Partner Violence (IPV) have possible alternative explanations, with most females having injuries that may have been produced by an assault by a stranger or another community member rather than by their partner. Repeated healed wounds in critical areas are the best indicator for IPV. For example, Walker, (2012) identified the case of an 18–25-year-old female from medieval St Mary Spital, London who had two healing mandibular fractures, a dental fracture, ante-mortem incisor loss and a healed fracture to the distal third of the left ulna. Other females from the cemetery had multiple rib fractures, distal ulna fractures, cranial, dental and facial injuries Walker (2012).


Novak (2009) found that only 7% of blunt force trauma in IPV resulted in fractures, 48% of which were injuries to the head and face, 20% to the upper limbs. Typical features were trauma to the incisors and canine teeth, orbital fractures, fractures of the mandible, zygomaxillary complex, and nasal bones, usually the result of forces applied anteriorly or laterally to the bone. The posterior head, neck, and lower limbs showed no evidence of fractures.


In the United States today. clinicians are legally obliged to inform the police when they believe that a victim of IPV has been admitted to hospital for treatment. Two extensive studies on accident and emergency admissions coded for IPV were carried out in the United States by Loder and Momper, (2020) and Porter et al. (2019). Loder and Momper’s 2020 study was conducted over nine years using data from 1.65 million admissions, 83.3% of whom were women with a median age of 28.8 years. The injuries consisted of contusions/abrasions (43.4%), lacerations (16.9%), strains/ sprains (15.6%), internal organ injuries (14.4%), and fractures (9.7%). Porter et al. (2019) used records from the National Trauma Data Bank from 2007 to 2014 identifying 1,352 records (1887 fractures) where the patient was diagnosed with a fracture associated with IPV . In archaeological collections fractures are the only evidence of violence and thus probably represent only 10% of all injuries sustained in assaults making any assessment of true prevalence of such injuries at best an estimate.

Porter et al. (2019) further subdivided fractures by facial and upper body bones. The face and skull accounting for 54.2% of total fractures.

Both studies located 88% of all fractures to the face, skull and upper body. Further subdivision in the Porter et al. (2019) study identified nasal bones (21%), skull (15%), orbital (13%), mandible (11.8%), zygo-maxillary complex (11.5%), ribs (17.5%), and vertebrae (14.5%) as typical fracture areas in IPV. Loder and Momper (2021) identified 38.9% of fractures coming from the upper body but just over half of these were bones of the hands whilst Porter et al. (2019) only found 3.7% of fractures in the hands. Porter et al. (2019) also identified fractures in distal areas of bones as more common in the upper extremities.


Repeat Injuries


Porter et al. (2019) state that injuries in multiple locations at various stages of healing suggest repeated assaults over a longer period of time. The most commonly associated fractures were facial and skull fractures (51.4%). 44.7% of patients presenting with pelvic fractures also had a vertebrae fracture 18% reported face and ribs, 19% reported face and upper extremities, 14% ribs and upper extremities.


Further sub-division of fractures to the hand in a study of 46 victims of IPV was carried out by Thomas et al. (2021). 12/27 were fractures to the fourth and fifth digits. All six metacarpal fractures were to the fifth digit (two shaft, two neck and one base). Of 12 patients with recurrent upper extremity injuries, 6 had recurrent injuries of the same hand.


Dental Injuries


Missing or fractured teeth are also a feature of assault. Garbin et al. (2012) studied police records from Brazil between 2001 and 2005. 1,844 patients were recorded as suffering from IPV. 15 (2%) suffered traumatic dental injuries caused by punches and slaps. The most frequently injured teeth were the maxillary incisors (31.8%), followed by the mandibular incisors (27.3%) and the maxillary canines (9.1%). Injuries to the incisors and canines in total were 68.2% of all injuries. Of the dental trauma cases, 59.1% were fractures, 27.2% were luxations and 13.7% were avulsions. Incisors or canines are the most common injury sites(Cybulski, 2013). Mandibular condylar fractures, mandibular body fractures and maxillary fractures are the fractures most associated with dental fractures, whilst zygomatic fractures are less associated with dental fracture (Adrieias-Garriga, 2019)

1.7 Judicial Violence in the Early Medieval Period


Execution


Decapitation as a means of execution requires a heavy bladed weapon such as an axe or sword involving a chopping motion as the blade is swung towards the neck usually producing in a cleft in the bone. Resultant lesions are linear with smooth surfaces. Skeletal evidence of decapitation in the form of cut marks to the cervical vertebrae was uncovered at a number of sites such as Bran Ditch in Cambridgeshire (Lethbridge and Palmer, 1929), Guildown in Surrey (Lowther, 1931) and Roche Court Down (Stone, 1932). Cessford et al. (2007, p210) identified decapitation as one or several blows to the cervical and occipital bones with associated fractures radiating away from the point of impact and sometimes evidence of damage to the scapula, the cranial base, the occipital bone, the mastoid process and the mandible which could also reflect an initially failed decapitation. Sometimes lower-level decapitations may also affect the thoracic vertebrae and the clavicles (Buckberry, 2014). Buckberry (2014) also identifies sharp force trauma to the anterior part of vertebral bodies as indicative of possible decapitation from the front.


Clough (2020. p87), reporting on the execution cemetery at Weyhill Road, Andover notes that most victims were executed with blows from the left or right side which mainly affected the third or fourth cervical vertebrae. She suggests that the four mandibles with cuts indicate that the head was angled downwards. Clough (2020, p85) also suggests that blows to the mandible may indicate the inexperience of the executioner with several cuts to the vertebrae. Skeleton SK1349 showed that more than one blow was required to sever the head. Single blows that removed the head may have indicated that decapitation took place after death when the body was still (Clough, 2020 p85).


The two types of ordeals mainly used in Anglo-Saxon England were ordeal by fire and ordeal by water. In the ordeal by fire, the offender would have to carry a heated iron rod in his hand for three paces, which was then bound for three days. When the bandages on the hand were unwrapped, if the hand was healed and unblemished the person was innocent, if the wound was infected the person was guilty. In the ordeal by water, the offender would either submerge their hand in boiling water, which would then be examined later for healing as in the trial by fire, or the entire body would be immersed in cold water and the offender would be found guilty if his body did not sink (Bartlett 1986, 1-2, 25-29; Foxhall Forbes 2013, 159-60). Ordeals had to be administered by a priest and were performed with the belief that if the judicial court did not have adequate information to judge the guilt of the offender, then the decision would be left to the judgement of omniscient God.





Figure 20: SFT to posterior of cervical vertebra on Skeleton 578 from Old Dairy Cottage, Sussex (Buckberry 2014 p13


Buckberry and Hadley, (2007) also identify heads from Walkington Wold Anglo-Saxon cemetery that have been decapitated but buried and displaced either elsewhere in the grave or buried separately before decomposition. In this case soft tissues hold in correct anatomical position the mandible, hyoid, and any vertebrae above the level of decapitation. The excavated remains will include the first, and possibly the second, cervical vertebra articulated with the cranium.


Long, linear and narrow incision wounds with a V-shaped profile and no corresponding blunt force trauma on the anterior of vertebrae are indicative of individuals who were executed by having their throats cut. In bones with good cortical preservation visible striations where several cuts of varying force may have been made are also indicative of an incision wound rather chopping sharp force trauma. In many cases levels of decay of the cortical surface or absence of critical bones may obscure evidence of sharp force trauma (Buckberry, 2014).

Execution by hanging rarely leaves evidence on bone. Where long-drop hanging has been employed, the second cervical vertebrae or axis will sometimes fracture (“Hangman’s fracture”) but even on examination of relatively recent victims of this method such fractures have proved to be rare James and Naysmith-Jones, 1992). Early medieval imagery suggests that gallows with a short drop were invariably used, and the victim placed on a cart that was removed (Waldron, 2009) (Figure 21) and death was caused by asphyxiation rather than fracture of the vertebrae which would usually leave no osteological evidence. The fracture of the hyoid bone has been identified as evidence of strangulation but hyoid bones whether intact or fractured from early medieval burials rarely survive due to their fragility and are invariably fractured post-mortem (Ubelaker 1992, 1217-19) and It is not conclusive evidence for hanging or strangulation ( Waldron 1996, 115; Aufderheide and Rodriguez-Martin 1998, 29). Two individuals at Weyhill Road Andover had fractures to the odontoid peg which may indicate hanging but such fractures are also caused by high velocity force such as being struck on the head by a falling tree (Schatzker et al. 1971).



Figure 21: Short drop hangings outside Bedford Castle dated 1189-1253. By Matthew Paris at Corpus Christi College, Cambridge ( c1200-1295).


Possible Archaeological evidence for gallows in the form of post holes two to three feet wide was found at Stockbridge Down execution cemetery (Hill1937, p252) and Sutton Hoo (Carver 2005, p331, 348).

Victims who may originally have had tied hands and laying in a prone position with wrists crossed behind their back could also be indicative of hanging, although tying materials have never been recovered (Reynolds, 2009). Execution by drowning also leaves no skeletal evidence. (Gatrell, 1994 p46, Poulton 1989 p81).

In some cases, disarticulated remains may indicate public display after execution. In this case individual bones will first fall from the suspended body where they are connected by labile joints. After relatively short periods, the hands, feet and possibly clavicles may have been lost before burial. After a longer period of display, joints such as at mandible, shoulder, knee or neck may separate. Initial disarticulation at the neck often occurs at the atlas–axis articulation, or at the axis–third-cervical articulation (Duday, 2009)) with the remainder of the cervical vertebrae attached to the rest of the skeleton. However, some joints are still likely to be found disarticulated in the grave, especially if they were placed in a coffin where there is no supporting soil to hold the joints in place Animal scavengers, ploughing or reburial might affect the process of disarticulation. The surviving level of articulation of both labile and persistent joints may enable inferences of how far a body had decomposed by the time of burial, (Duday and Guillion, 2006).


Skeletons with bound legs may indicate that the corpse has been suspended upside down for public display. Skeletons bent over forwards or backwards in their graves may represent burials of individuals strangled or decapitated whilst kneeling in their graves. Execution by stoning would result in multiple blunt force trauma to the cranial and post cranial skeleton. Early Medieval examples have yet to be identified or discussed (Reynolds and Cessford et al.2007).


Mutilations


Corporal punishments involving mutilation are listed in Anglo-Saxon law codes such as I Ine 18 and 38, Oliver (2002) and Alfred L32 ( Baker, 2204 p186). They include amputation of the hand or foot. Most other forms of corporal punishment such as burning, scalding, whipping, or the mutilation of eyes, ears, and nose, would usually only have affected soft tissue rather than the skeleton and are therefore unlikely to be identifiable on the skeleton.

Many victims of amputation would show evidence of healing such as callus formation at the site of the amputation and eventually a smooth and rounded surface and deposits of uneven bone with possible cloacae for drainage of pus if osteomyelitis had set in. Over a longer period of time the bone may atrophy through lack of use leading to an increase in robusticity of the opposite limb. Amputation tool mark striations should also be visible on the cut surface. Evidence from cemetery sites indicate possible surgical amputation (Mays, 1996). Skeleton SK 1240 from the Weyhill Road Cemetery, Andover had both hands removed with evidence of chop marks across the carpals. There was no evidence of healing (Clough, 2020 p89).


Battle Victims


For burials to be identified as victims of battle several characteristics need to be present; the victims should be buried together at the same time and separate from the community burials or in a mass grave (Loe et al. 2014).They should show many examples of sharp force trauma and be predominantly men aged 18-45 (Loe et al. 2014). Examples include five individuals out of a cemetery of 22 buried at Skakenoak villa in Oxfordshire, (Brodribb, Hands, and Walker 1973). At Fishergate in York 11th Century burials included eight individuals lying separately from the rest of the cemetery with five individuals arranged in rows suggesting that they were buried at the same time (Stroud and Kemp 1993) . At Heronbridge cemetery near Chester 20 male burials aged 18 to 45 with no females or children all showing evidence of sharp force trauma were interred in a mass grave. The grave consisted of two rows of skeletons, aligned west to east, with the upper row overlying the feet and lower legs of the lower row. The cemetery has been linked to the seventh century Battle of Chester (Holst, 2004). At Ridgeway Hill , Weymouth50 adult males were found co-mingled in a mass grave from the 10th century. A total of 39 (78%) individuals showed evidence of peri-mortem sharp-force trauma to the crania, mandibles and cervical vertebrae associated with decapitation. The age at death of the victims corresponded with the age at death of the two Heronbridge skeletons with 40 out of 42 victims aged 18 to 45 (Loe et al. 2014).

Case studies from Eccles (Manchester and Elmhirst, 1982) and Sedgeford (Anderson, 1996) suggest that Individuals with SFT in settlement cemeteries had been buried alone in different areas of the cemetery and at different phases. They may have been victims of battle who were transported to their local cemetery, but this cannot be verified. In England only men have been found in battle cemeteries and predominantly men in the 18 – 45 age group. None of the cemeteries identified as battle cemeteries at Shakenoake ( Brodribb, et al. 1973), York, (Stroud and Kemp, 1993), Cheste,r(Holst, 2004) and Heronbridge (Loe et al. 2014) contain female skeletons.


1.9 The timing of Blunt and Sharp Force Trauma


Ante-mortem injuries

Skeletal wounds are identified as either antemortem, peri-mortem, or post-mortem, depending on the characteristics of the fracture margin (Merbs 1989; Sauer 1998). Understanding the timing of violent injuries is vitally important in order to assess whether injuries occurred after the time of death, or before death and therefore showing signs of healing or at the time of death. Features of cranial antemortem injuries are the presence of an impact area, rounding of the fractured edges and possible exposure of underlying bone structure (Byers 2005; Galloway et al. 2013). Porosity of the cortical surface near the fractured end is an indication of reabsorption, fracture healing, and remodelling that can obscure the original injury site(Galloway et al. 2013). Remodelling gradually




Figure 22: Flaking (A), (B), layered breakage (B) crushed margins (C) (Scheirs et al. 2017, p6-7),


converts the hard callus to mature bone and can usually still be recognized by the retention of some altered morphology (Ubelaker and Montaperto, 2013).

Sledzik and Barbian (1997) in a modern study of 127 crania noted that earliest healing response developed after five days. Sauer (1998) in an investigation of the crania of 257 American Civil War victims suggests remodelling usually begins after seven days However, caution should be exercised in attributing timing of perimortem injuries. For example, Sledzik, and Barbian, (2008) also found that some of the cranial injuries in their study had no evidence of healing until 78 days following the injury. Remodelling can continue for up to seven years according to McKinley (2003).


Fractures to the long bones of the post cranial skeleton are often on their own survivable and usually relatively easily identified by a callus forming during bone repair (Sledzik and Barbian, 2008).

Wenham, (1989 p137) states that clean sharp cuts to bone can only be inflicted when the victim was alive or recently alive. Decomposition leads to bones becoming more brittle and therefore damage caused by factors such as weathering, animals and root growth lead to fracture lines that are parallel or perpendicular to the grain of the bone. Post-mortem breaks splinter with edges that show more irregular patterns and breaks that are around ninety degrees from the bone surface. Fresh bone fractures on the other hand tend to produce acute or obtuse angles and sharp edges (Figure 25.p29).Fracture margins take on a different appearance when damage occurs post-mortem. Factors such as ground pressure, plant roots, rodent gnawing, and large equipment movements can all cause post-mortem alteration.


Calce and Rogers (2007) using pig skulls, examined 88 post-cranial fractures. 88.68% perimortem fractures presented oblique or acute angles while 73.68% of the post-mortem fractures showed right angles. Fractures in fresh bone are uniform in colouration on exposed bone surfaces, whereas in post-mortem breakages the ends of bones display lighter, often cream colouring.

However, post-mortem breakage that occurred while the bone maintained its elasticity on the post- cranial skeleton can also be confused with perimortem damage. In addition, antemortem fracturing that has not yet developed macroscopic evidence of healing can lead to inaccurate assessment of injury timing (Sledzik and Barbian, 2008). Scheirs et al. (2017) using 21 bones fractured soon after death when the bones were still elastic, identified five characteristics to distinguish between perimortem and fresh post-mortem fractures: layered breakage, bone scales, crushed margins, flakes with flake defect and wave lines were representative of perimortem rather than fresh post-mortem fractures (Figure 22). However, Cattaneo and Capella, (2017) note that little research has been carried out into the accuracy of these descriptions.


Conclusions


In the search for evidence of violence towards women, differentiation between accidental and deliberate trauma needs to be made wherever possible. In general, fractures to the feet, tibia, fibula, humerus, radius and spine are more likely to be evidence of accidental trauma while deliberate trauma is usually directed at the face and cranium and often the left side or the upper post-cranial skeleton. Deliberate sharp force trauma can occur anywhere on the skeleton but is also most often directed at the cranium. Examples of blunt or sharp force trauma in the archaeological record may need re-examination to confirm that injuries were the result of intentional violence and to confirm accurate sexing of individuals in some cases. Skeletal manifestations of common assault by strangers are indistinguishable from intimate partner violence although repeated healed wounds may indicate a close connection with one violent individual (Redfern, 2013).


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