The course of the shrapnel ball was from within outward, striking the femur with the energy of high (shrapnel) velocity, with fragmentation of the missile by impact on the bone. The largest fragment, by the distinct outline of its shadow, lies close to the plate and behind the bone; a smaller metal fragment has been carried to the outer border of the thigh, where it lies superficially; another fragment lies in the seat of fracture.
The position of fragments is faulty, as the indications for extension and abduction have not been wholly met, although this is a case from the well-conducted service of Gulhané Hospital.
The treatment in such cases is conservative and the results are good.
Plate 122.
Shrapnel—Plate 122.
LOWER EXTREMITY.
Gunshot Fracture of the Shaft of the Femur,
with Lodgment of the Missile.
The shrapnel ball, in its almost directly antero-posterior course from behind forward, has delivered the energy of high (shrapnel) velocity to the bone, which had absorbed it all in stopping the missile, with a resulting approach to a butterfly fracture with displacement of fragments.
The upper end of the lower fragment lies nearer to the plate than to the lower end of the upper fragment, with the deformed shrapnel ball lying behind the latter, closer to the plate.