A type III odontoid fracture of the axis (C2) from the Middle Archaic of the Texas Gulf Coastal plains

The Ernest Witte site (41AU36) is a large prehistoric cemetery located in southeast Texas. Four discrete burial groups were excavated from 1974-1975, the oldest dating to the Middle Archaic (3000-1500 B. C.). While examining the burials from this group, a 35-50 year old adult male was found with a partially healed Type III fracture of the odontoid process of the axis (C2). A review of the clinical literature was undertaken to help determine how this injury could have been sustained and survived in an Archaic setting. The most frequent modern causes for this injury include 1) motor vehicle accidents, 2) falls from heights, and 3) severe blows to the back of the head. Given the etiology of odontoid fractures, it is not possible to determine if the break was caused by intentional or accidental violence. Type III fractures are frequently associated with severe neurological complications, including death. While this individual survived long enough for the break to partially heal, the injury probably caused his demise.