170 Injuries of Bone. 



— macerated, to show the above. The epiphyseal line is still 

 visible. 



" The ball passed through the head of the tibia, and must 

 have broken upon the continuity of the capsular membrane ; 

 but this man got so well as to have been brought up to York 

 Hospital for the purpose of being examined for a pension, when 

 irritation and inflammation commenced, which made it neces- 

 sary to amputate " (Sir Charles Bell). 



The bullet has perforated, without splitting, the front of 

 the head, New bone has been formed round the openings, 

 especially on the outer side, and also on the front of the tibia 

 for about three inches below the injured spot. There is a slight 

 deposit on the head of the fibula. B. C. xvii. 30. 



3. 356. Bullet lodged in the Upper End of the Tibia, fol- 

 lowed by acute Osteo-myelitis and Necrosis of the 



Shaft. — Upper two-thirds of the right tibia of a young adult 

 (epiphyseal line still visible) — macerated, to show the above. 



The Avound was received at the battle of Waterloo. Abscess and 

 caries made amputation necessary. 



The bullet, which is a round one, is lodged intact in a 

 large cavity in the cancellous tissue at the back of the upper 

 end of the bone. On the front of the shaft a large part of the 

 compact tissue has necrosed. This dead piece has been 

 partially separated above, while below its surface has been 

 partly absorbed by granulations, and is in consequence very 

 rough. A piece cut out of it shows that the separation was 

 also proceeding from below. The rest of the shaft, especially 

 at the back, is encnisted with new periosteal bone. Apparently, 

 therefore, an acute osteo-myelitis following the injury produced 

 by the bullet has ended in necrosis. B. C. xvii. 32. 



3. 357. Bullet lodgred in the Upper End of the Tibia, 

 followed by Osteo-myelitis and Necrosis of the 



