A new approach to recording nasal fracture in skeletonized individuals.

OBJECTIVE

This work describes a new method for recording nasal fracture in skeletonized individuals, suitable for use in biocultural studies of violence and fracture in past societies.

METHODS

The method consists in recording the 'side of fracture', 'side of deviation', 'type of fracture', 'other facial fractures', and stage of 'bone remodeling'.

RESULTS

A lateral impact force to the facial area is typical of interpersonal violence. This may result in a unilateral nasal fracture and/or a laterally deviated nose. Given the predominance of right-handedness in human populations, side of fracture and, especially, side of deviation, may be useful indices of interpersonal violence. As regards fracture type, although a distal fracture of the nasal bones is the most common type, their comminution may be associated with higher impact forces. The presence of other facial fractures may also be an indicator of high-energy impacts.

CONCLUSIONS

Different patterns of nasal trauma may be consistent with different etiologies.

SIGNIFICANCE: The method is focused at improving our ability to distinguish the direction and type of impact that caused the injury and, in particular, whether, at a population or sub-group level, such injuries are likely to be predominantly due to violence or to other causes.

LIMITATIONS: Well healed fractures of the nasal bones or injury to the septum may be difficult to identify. Also, it is not possible to confirm if nasal and other facial fractures are temporally concurrent.

SUGGESTIONS FOR FURTHER RESEARCH: To test this method using skeletal collections with known trauma history or 3D prints of modern nasal injuries of known etiologies.