Bone Damage in the Antemortem, Perimortem, and Postmortem

Periods: Looking for Traumatic Indications on Bones for Assessing the

Quality of Life of Skeletal Remains

Ledy Ana Zulfatunnadiroh

, Eko Prastyo

, Reinaldy Octavianus Yan Dimpudus

, Myrtati Dyah

Artaria

Forensic Science Study Program, Post Graduate Studies, Universitas Airlangga, Surabaya

The Department of Anthropology, FISIP, Universitas Airlangga, Jl. Airlangga 4-6 Surabaya 60286, Indonesia

Keywords: Antemortem, perimortem, postmortem, forensic anthropology, trauma

Abstract: The analysis of damages and changes to skeletal remains may help relate to the circumstances of death and

or individual identification. Those changes are, for example, the physical properties of bone. Meanwhile,

trauma refers to physical disturbance of living tissue due to external forces. Trauma and skeletal damage

analyzes include the approximate time of trauma compared to the time of death, the mechanism, and the

kind of forces that have caused the trauma. The materials for this study were 1 individual from the Museum

of Anthropology, and 9 individuals from the collection of human skeletal remains at the Department of

Anatomy and Histology, Physical Anthropology Section, in Universitas Airlangga. We observed the shape,

the colour, and the texture; and analyzed if there were any antemortem trauma and/or abnormality of bones

that happened during the life of the individuals. The damage to the skeletons observed in this research were

mostly postmortem damage. Most of the damages did not show any healing process and appeared brighter

than the surrounding bone, and had a jagged—irregular—and sharp edges. However, we also found signs of

abnormal bones that were caused by the poor condition during the life of some of the skeletal remains.

Postmortem damage can be differentiated from the antemortem trauma. This finding is important for further

study in assessing the quality of life of people in Indonesia in the past, and for giving aids during

identification, through unique characteristics observed on the skeletons.

1 INTRODUCTION

Forensic anthropologists use the principles of bone

biomechanics to support trauma to bones. Bone

biomechanics is determined by the material and

structural properties (intrinsic variables) and the

nature of the load (extrinsic variable) imposed. The

intrinsic variables consist of material properties such

as bone microstructure, cortical thickness, and

trabecular thickness, while structural properties

include bone morphology (ie, size and shape).

Extrinsic variables include the magnitude, direction,

rate, extent of use, and the duration of load applied

to the bone. Simply put, intrinsic variables are

related to weapons or objects that cause injury

(Tersigni-Tarrant & Natalie, 2013).

The analysis of trauma and other changes to the

skeleton can help relate to the circumstances of

death or the identification of individuals. This

change is a change in the physical properties of

bone, whereas trauma refers to the physical

disturbance of living tissue due to external forces.

The conclusions derived from the skeletal trauma

analysis include the relative time spent on the event

of death, and the mechanism or type of force that

causes trauma. Time of trauma can be categorized as

antemortem (occurring before death) or perimortem

(occurring around the time of death). Postmortem

changes are not considered traumatized (because

they do not interfere the living tissue). The

mechanism of trauma is categorized as a blunt force,

sharp, high strength, thermal, or some combination

of these categories (Christensen et al., 2014).

Zulfatunnadiroh, L., Prastyo, E., Dimpudus, R. and Artaria, M.

Bone Damage in the Antemortem, Perimortem, and Postmortem Periods: Looking for Traumatic Indications on Bones for Assessing the Quality of Life of Skeletal Remains.

DOI: 10.5220/0007544404310435

In Proceedings of the 2nd International Conference Postgraduate School (ICPS 2018), pages 431-435

ISBN: 978-989-758-348-3

431

2 MATERIAL AND METHOD

This research material were from 1 individual

skeletal bone collection of Museum of

Anthropology, Faculty of Social and Political

Sciences, Universitas Airlangga and 9 individuals

from Department of Anatomy and Histology,

Physical Anthropology Section, in Universitas

Airlangga. Observation was done by observing the

shape, colour, and texture, as well as analyzing

whether there were antemortem trauma and/or bone

abnormalities that occur during individual life

processes.

Figure 1: Zygomatic dextra bone

Figure 2: Ulna dextra bone

Figure 3: Costae sinistra bone

Figure 4: Tibia sinistra bone

Figure 5: Femur sinistra bone

Figure 6: Tibia sinistra bone

Figure 7: Fibula dextra bone

ICPS 2018 - 2nd International Conference Postgraduate School

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Figure 8: Cranium bone

Figure 9: Pelvic bone

Figure 10: Sacrum bone

3 RESULTS

Table 1: Skeletons are observed with the type of period

from its shape, colour, and texture.

According to Table 1, the framework damage

observed in this study was largely postmortem

damage. The damage did not seem to be a healing

process. Zygomatic, ulna, costae, fibula, and

cranium bones fracture had a jagged (irregular)

shape and sharp edge, also appeared to be brighter

than the surrounding bone. Femur sinistra bone had

a not jagged (regular) fracture and the colour was

same with the surrounding bone. However, we also

found abnormal bone marks caused by conditions

during the life of some bones, such as on tibia

sinistra, pelvic, and sacrum bones.

4 DISCUSSION

Antemortem trauma, occurring before the time of

death, is characterized by an osteogenic reaction

(new bone formation) of visible healing at the site of

injury, since naturally the reaction occurs when the

individual is alive. Fracture healing can be

demonstrated with the tip of a rounded fracture or

callus formation whereas an infection response is

indicated by a proliferative or lytic lesion

(Christensen et al., 2014).

The presence of antemortem trauma to

unidentified skeletons serves as information that can

be useful in the identification process. Thus, our

ability to recognize, interpret, and know the

antemortem fracture time is the key with accurate

resolution in many death investigations. Most of the

forensic anthropologists are familiar with the basic

healing process of bone fracture, which involves

inflammation, the development of soft callus and

hard callus, as well as remodeling. Therefore, an

understanding of the normal process of bone growth

Bone Damage in the Antemortem, Perimortem, and Postmortem Periods: Looking for Traumatic Indications on Bones for Assessing the

Quality of Life of Skeletal Remains

433

is necessary for basic anatomical considerations for

bone healing (Boyd & Donna, 2018).

In the pelvic and sacrum bones (Figure 9 and

10), bone abnormalities occured during life. The

pelvic bone was thought to be due to osteoporosis so

that the bone appeared porous (small holes). The

sacrum did not appear to blend between the two

sides (there was a gap) so that it was assumed that

the individual had a history of spina bifida

abnormalities.

Pathology refers to the disease, and the

pathological condition is an abnormal anatomy that

is a manifestation of a disease process. The process

of this disease can be due to infection, injury, or

abnormalities. Not all diseases affect the skeleton,

but can manifest as bone changes locally called

lesions. Pathological lesions of bone can be

proliferative, lytic, or deformative. Proliferative

lesions (osteo proliferative) are characterized by

excess bone deposition, while lytic (osteolytic)

lesions involve bone loss (Christensen et al., 2014).

However, a more detailed temporal specification

of antemortem time would be desirable, since a more

precise “dating” would aid palaeopathologists and

forensic anthropologists in interpreting facets such

as medical status and medical care at the time of

death (Boer et al., 2012).

Tibia sinistra bone (Figure 4) had an irreguler

bulge shape, same colour with the surrounding bone,

and rough texture was thought to be ostophytes. The

tibia sinistra bone (Figure 6) appeared to be worn

out (attrition) with smooth surface in the joint or the

meeting of the two bones caused by excessive use

during life.

Repeated mechanical stresses on the skeleton can

cause the bones to adapt their morphology in

response to these stresses. These adaptions are

somestimes called ”markers of occupational stress”

or “occupational markers”, in reference to their

origins of often resulting from work-related physical

activities (Christensen et al., 2014).

Trauma to the soft tissues that cause death often

involves bones in deliberate attacks either sharp or

blunt on the persecution, and the type of trauma

around this time of death is called perimortem

trauma (Indriati, 2010). Perimortem trauma refers to

an injury that occurs relatively close to the time of

death, but not necessarily “on” the death time.

Trauma may occur immediately before, during, or

after the death. Perimortem trauma to the bone is

identified as an injury that occurs when the bones

are in a fresh state biomechanically (Christensen et

al., 2014).

In perimortem injury, the pattern of bone

destruction is similar to that of antemortem trauma

but does not indicate a cure or infection response.

Because of the bones are still “green” or fresh when

there is trauma, the fracture tips appear sharp and

clean-not jagged and torn like broken ends of the

shin bone. Compared with postmortem, fresh bone

fractures are often more straight while dry bone

fractures tend to appear jagged. As seen in the femur

sinistra (Figure 5) which had a regular (not jagged)

shape which was estimated to occur in the

perimortem period. Perimortem trauma can provide

valuable information about the cause and/or way of

death (Burns & Karen, 2013; Christensen et al.,

2014).

Perimortem trauma is traditionally denoted by

wet or fresh fracture characteristics such as oblique

fracture angles, a smooth fracture surface, and

curved or V-shaped fracture outlines. Conversely,

postmortem damage is denoted by dry

fracture characteristics such as right angles, a

rough fracture surface, and a transverse or jagged

fracture outline. In addition, a lighter coloration of

the fracture surface is consistent with a recent

postmortem fracture (Green & Schultz, 2016). In

literature, there are already many characteristics

known to make the distinction between perimortem

and postmortem fractures like colour, smooth and

rough edges (Scheirs et al., 2017).

The fracture of zygomatic, ulna, costae, fibula,

and cranium bones (Figure 1, 2, 3, 7, and 8) had

irreguler (jagged) shape with sharp edges. Trauma or

postmortem damage is a damage that occurs long

after death. The edges are sharp and the bone tends

to be completely broken, not partially or with a bent

tip like a greenstick fracture (Christensen et al.,

2014).

Biomechanically, the reason for different

postmortem fracture is because dry bones respond to

different styles of fresh bone. The living bones

contain moisture and collagen, which gives greater

elasticity (Turner and Burr, 1993). Fresh bones

contain water, which serves to absorb and remove

some energy (called viscoelasticity). When the

bones dry out, the bones no longer have the power to

absorb energy, so the mechanical properties change

and look like inorganic materials. This response is

similar to a branch or twig that dries up its water

content so that it gets easily broken (Christensen et

al., 2014).

During the postmortem period, the loss of the

organic content and moisture changes the

viscoelastic composition of bone, which causes dry

bone to be more brittle and stiff, rather than elastic

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and stiff. As a result, dry bone is less adept at

resisting strain and fractures differently than wet

bone during the perimortem period (Green &

Schultz, 2016). Broken bone surfaces tend to be

smooth in fresh bone, but tend to be grainy and

powdery in dry bone (Jordana et al., 2013). Dry

bone is much more brittle, causing fracture lines to

run along or perpendicular to the grain of the bone

causing jagged edges (Scheirs et al., 2017).

Forensic anthropologists (Maples, 1986, Sauer

1998) have determined that there is a difference

between postmortem and perimortem fracture

patterns. Both perimortem and postmortem trauma

show no sign of healing, but postmortem damage is

recognizable because it looks bright, unlike living

bone, such as where the perimortem fracture is

coloured by bleeding, decomposition fluid, soil or

other materials. The bony ends of the bone damaged

by the postmortem will appear brighter than the

surrounding bone because these surfaces are

exposed for longer periods by the environment.

(Christensen et al., 2014). This is what causes

postmortem trauma to have a brighter color than its

surroundings, as seen in zygomatic, ulna, costae,

fibula, and cranium bones.

However, colours can change again after

alteration due to acquired patina through the years.

This means that, if there is no colour difference, it

does not necessarily mean that the fracture can only

be perimortem (Scheirs et al., 2017).

It is important to distinguish between perimortem

and postmortem, since perimortem events have

much greater forensic involvement. Perimortem

trauma may be caused by a murderer, whereas

postmortem damage is more likely to be caused by

animal excavation or inadvertent excavator use.

Similarly, damage to the skeleton may occur during

collection and transportation (Byers, 2010; Burns &

Karen, 2013), as seen in the ulna bone (Figure 2)

appeared to be caused by sharp object, which might

occur during the excavation.

5 CONCLUSIONS

Postmortem damage can be differentiated from the

antemortem and perimortem trauma. Postmortem

damage can be recognized because it looks bright,

unlike the living bone (still fresh). Fresh bones

mainly consist of organic materials, collagen, and

water. When the bone dries and the water

component is lost, the bones become harder and

stiffer, so the characteristics turn out to be more

fragile and lose their elasticity. The edges are sharp

and the bones tend to be completely broken. This

finding is important for further study in assessing the

quality of life of people in Indonesia in the past, and

for giving aids during identification, through unique

characteristics observed on the skeletons.

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