G^mshot Fractures of the Tibia. 171 



Cancellous Tissue. — Upper end of the left tibia of a young 

 adult — macerated, to show the above. A bullet is wired in a 

 cavity in the head. 



The injury was sustained at Waterloo. The extensive suppuration 

 made amputation necessary. 



The space round the ball contains a large fragment of 

 cancellous bone, and some new periosteal bone has formed down 

 the front of the shaft, but for a short distance only. 



B. C. XVII. 31. 



3. 358. Bullet lodged in the Knee, followed by Tuberculosis. 



Upper end of a right tibia — macerated, showing the above. A 

 bullet is wired in position on the top of the outer tuberosity. 



The articular surface is very irregular, being occupied by 

 excavations. The walls of these are opened out, although one 

 at the back shows signs of healing. On the outer condyle an 

 island of necrotic bone remains, with its articular surface 

 unchanged, and surrounded by a deep trench. At one or two 

 other places similar though smaller islands are seen. These 

 appearances are identical with those seen in advanced tuber- 

 cular disease. 



The surface of the bone below the articulation is much 

 roughened by newly formed periosteal bone. This indicates 

 that sepsis has accompanied the tubercular process. 



F. P. C. 245. 



3. 359. Gunshot Fracture of the Tibia and Fibula.— 



Right tibia and fibula — macerated, showing the above. The 

 fragments are wired together. 



"This may give a picture of the state of the French wounded 

 (Waterloo), who were brought into Brussels upon waggons, fourteen days 

 after the battle, and were never dressed before that time " (Sir Charles. 

 Bell). 



The part of the tibia struck has been comminuted into- 

 many pieces, most of which are loose. Fissures, however, do 

 not run beyond the shaft. The fibula has been broken across. 



