Wound of exit, external border over head of radius.
The course of the bullet was diagonally anteroposterior from within outward, striking the posterior border of the upper end of the ulna and passing through the head of the radius, carrying the fragments of the latter before it and lacerating the wound of exit. The energy of impact also fissured the upper end of the shaft of the ulna and fractured the neck of the radius without detaching the large fragments.
This is the effect of a rifle bullet at short range, or possibly a ricochet shot at mid range.
The emergency treatment is antiseptic dressing with splint immobilization.
The subsequent treatment is conservative, whether the wound is clean or infected. The course of treatment of such an infected wound might extend from four to six months.
Note.—As the soldier always escapes the burden of explanation when the wound of entrance is anterior rather than posterior, it should be remembered that the forearm may occupy positions in relation to the body which exposes the anatomically posterior aspect of the forearm to missiles directed toward the anterior surface of the body; and as the wounds of the forearm herein presented are described in the anatomical position, there is no justifiable impeachment of the soldier’s valor in an inference that he was shot from behind when the wound of entrance involves the posterior aspect of the forearm.
Plate 21.
Rifle—Plate 21.