nge unknown, probably either mean or long.
The bullet entered from the front, grooved the under surface of the
acromial end of the clavicle with increasing depth, and eventually
perforated the posterior margin of the bone, raising the compact tissue
in an angular manner.
The commencement of an incomplete groove extending from the anterior
margin is seen, resembling the groove of the humerus, fig. 58.]
1. _Stellate comminuted fractures._--A shows the primary nature of the
lesion in all comminuted fractures of compact bone, consisting in the
production of a number of radiating fissures, which assume a stellate
form of which the point of impact corresponds to the centre. B shows an
incomplete development of this form, the fragments being simply
displaced laterally with slight loss of substance, so as to simulate a
real punctured fracture. An illustration of this fracture produced by a
bullet travelling at a low degree of velocity is seen in plate XXIII.,
which also shows the unaltered bullet lying in close proximity to the
injured fibula.
The degree of comminution in these fractures depends first on the range
of fire and consequent striking force retained by the bullet, a high
degree of velocity producing extreme comminution of compact bone. The
severity of the latter again may be influenced by the measure of
resistance dependent on the density and brittleness of any individual
bone, or on the possession of the same characters as a special property
by the tissues of the man struck. Thus plate IV. shows a fracture of the
humerus produced by a bullet shot from a short range, and the fragments
are comparatively large and of even dimensions, while plate XIV. shows
extreme comminution of the portion of the femur exposed to direct
impact, with elongated large fragments at the sides of the track. Plate
XIX. shows less extreme comminution and less separation of the
fragments, and was probably produced by a bullet from a longer range of
fire.
The separation of elongated lateral fragments is a special feature, and
best marked when the portion of bone struck is considerably wider than
the bullet, as in the case of the shaft of the femur. These fragments
correspond in the method of their production to those seen in the wedge
fractures described below, while their separation leaves a pointed
extremity to either segment of the shaft. This fracture in its purest
type is, I believe, spoken of as the 'butterfly fracture.'
With
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