Gunshot Fractures of the Tibia. 173 



Lower three-fourths of a right tibia and fibula — macerated, 

 showing the above. The fragments are wired in position. 



"The fracture of the tibia and fibula would not have warranted 

 amputation, had the foot not also been shattered. Remark. — Indeed, if 

 the majority of these eases of gunshot fracture had been treated early, 

 and free incisions made down to the bone, many of them might have 

 done well, without amputation. It was the circumstances in which they 

 were found that made amputation necessary, and at the same time almost 

 a hopeless measure " (Sir Charles Bell). 



The fibula is broken irregularly, and the tibia comminuted. 



The comminution of the tibia, however, is less than in the 

 previous specimens, but the splitting of the remaining portions 

 of the shaft is somewhat more extensive. A layer of newly 

 formed periosteal bone, slightly thicker than in the preceding 

 specimens, is seen above and below the seat of injury. 



B. C. XVII. 47. 



3. 364. Gunshot Fracture of the Tibia.— Upper end of a left 



tibia — macerated, to show the above. One loose piece is wired 

 in position. 



The wound was received at "Waterloo. 



Necrosis has been present at the seat of fracture, and the 

 line of separation has begun. New periosteal bone has been 

 thrown out on the adjacent portion of the shaft. 



F. P. C. 252. 

 Presented by Professor John Thomson. 



3. 365. Gunshot Fracture of the Tibia.— Portion of the shaft 

 of a tibia — macerated, showing the above. 

 The patient was wounded at Waterloo. 



The features of this specimen are essentially similar to 

 those of the foregoing, there being indications of a septic 

 compound fracture. Necrosis has begun at the seat of fracture, 

 and new periosteal bone has been thrown out on the adjacent 

 portion of the shaft. F. P. C. 251. 



Presented hy Professor John Thomson. 



