The course of the missile was transverse from without inward, with a transverse fracture and fragmentation.

This wound might have been caused by either a shrapnel ball or a deformed rifle bullet, but the distribution of the metallic fragments rather indicate the course of a shrapnel ball.

The metallic fragments lie farther from the plate than the safety pin of the dressing, which, therefore, lies behind the bone and the fragments of the missile lie in front.

The treatment in such cases is conservative and the results are favorable. The subsequent course may indicate interference for mal-union.

Plate 91.

Shrapnel—Plate 91.

UPPER EXTREMITY.
Gunshot Fracture of the Left Humerus.

The course of the missile has been from without inward. The fragments of metal marking the path of the missile lie farther from the plate on the outer than on the inner side. This would indicate the former to be in front of the bone and the latter to be behind. The wound could have been caused by either a deformed rifle bullet or by a shrapnel ball, but the distribution of metallic fragments along the track of the missile rather indicates the agent to have been a shrapnel ball.