Gunshot Fractures of the Tibia. 179 



The bullet still preserves its conical shape, although it has 

 been rendered in-egular by impact against the bone. It has 

 forced itself partly into the outer condyle, and has partly split it 

 off. The bullet, however, has had but a shallow bed, and, except 

 for the surrounding soft parts, must have been loose. It is 

 now held in place by a wire. G. C. 3426. 



Presented by Surgeon-General Billings, U.S.A. 



3. 383. Gunshot Fracture of the Upper End of the Tibia 

 and Fibula. — Upper end of a right tibia and corresponding 

 part of the fibula, except the head, which is wanting. The 

 specimen is macerated, and the fragments wired together, to 

 show the above. 



There is great comminution of the tibia, and loss of sub- 

 stance. An irregular hole, larger on the outer side, is seen on 

 either side of the tibia, below the articular surface. The sur- 

 rounding bone is comminuted into numerous fragments, and the 

 knee-joint has been extensively involved. G. C. 3427. 



Presented by Surgeon-General Billings, U.S.A. 



3. 384. Lodging of a Bullet in the Head of the Tibia 



after Penetration. — Upper end of a left tibia and fibula — 

 macerated, showing changes from the above injury. 



A conical bullet is seen with its tip just emerging at the 

 back of the inner tuberosity, 'having passed obliquely backwards 

 from the front and outer side. There is considerable loss of 

 substance in the track of the bullet, which has split the bone, 

 and, at the back, wedged the portions aside. The splitting 

 extends for about four and a half inches down the shaft. Some 

 cloth surrounds the back of the bullet, having evidently been 

 carried in with it. G. C. 3428. 



Presented by Surgeon-General Billings, U.S.A. 



