Gunshot Fractures of the Tibia. 181 



tures is greatly comminuted, especially at the back and outer 

 side, but there is comparatively little splitting upwards, and 

 none down-wards beyond the fragments. The fibula is broken 

 a little above the point where the bullet struck the tibia, and 

 may have been secondary to the fracture of the tibia. Some 

 new periosteal bone has formed at and near the injured places. 

 The bullet evidently struck the tibia from the outer side, and 

 carried away bone before it on the inside. G. C. 3431. 



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



3. 388. Gunshot Fracture of the Lower End of the Tibia. 



— Lower end of a left tibia and fibula — macerated, with the 

 fragments wired together. 



There is an irregular aperture in front of the tibia two 

 inches above the articular surface. The margins are bevelled 

 towards the inside. At the back of the bone opposite there 

 is another aperture, somewhat smaller and more irregular than 

 that in front, with its margins bevelled externally. The inner 

 malleolus and half of the articular surface is split off from the 

 rest of the bone, and the fissures extend upwards into the shaft 

 for some inches above the seat of injury. The bullet has 

 evidently struck the leg from the front and outer side, and has 

 passed backwards and slightly downwards. G. C. 3432. 



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



3. 389. Gunshot Fracture of the Bones forming" the 

 Ankle-Joint. — Lower ends of a right tibia and fibula, with 

 the astragalus and os calcis — macerated, showing the effects of 

 gunshot injury at the back of the ankle. 



The outer malleolus has been carried entirely away, and 

 the adjacent parts of the astragalus and tibia are ploughed up. 

 The ball has apparently passed obliquely from before back- 

 wards. G. C. 3433. 

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



