FREE BOOKS

Author's List




PREV.   NEXT  
|<   142   143   144   145   146   147   148   149   150   151   152   153   154   155   156   157   158   159   160   161   162   163   164   165   166  
167   168   169   170   171   172   173   174   175   176   177   178   179   180   181   182   183   184   185   186   187   188   189   190   191   >>   >|  
in an oblique direction. It will be of course recognised that the exact impact of the bullet depends not alone on the direction of the projectile, but also on the nature of the slope offered by the surface of bone struck. 2. _Wedge fractures._--This form (C and D, fig. 50) is equally characteristic of gunshot injury with pure perforation; it is met with in two varieties. C illustrates the more strongly marked type; in it the bullet makes passing lateral impact with the shaft, and from the point struck radiating fissures extend to the opposite margin, so that a wedge-shaped piece of bone often secondarily comminuted is separated from the remainder of the shaft; see plate X. of the radius. The second variety, D, is an incomplete development of the stellate fracture in which the fissures pass to one margin of the bone only. The explanation of this variation is probably to be sought in the direction of impact on the part of the bullet, since the main fissure is often accompanied by secondary lines which run a somewhat parallel course to the main one, and suggest the dispersion of the force in the form of concentric waves. Such fractures were most strongly marked in the tibia, the breadth of the surfaces of this bone presenting especially favourable conditions for their production. 3. _Notched fractures._--These may be a slight degree of the form of wedge fracture last described; such a one is depicted in plate XXII. where a portion of the spine of the tibia has been carried away by a passing bullet. Other notched fractures approximate themselves more nearly to perforations, the notch being a groove secondary to the opening up of such a track as is shown in the illustration of a perforation of the lower third of the shaft of the tibia (fig. 57 on p. 219). Notching or grooving is naturally much more common in the cancellous portions of bones. 4. _Oblique fractures._--These also occur in two varieties: the first has been already alluded to; in it the bullet actually cuts an oblique track in the bone; the main line of fracture is often considerably comminuted, usually at the proximal end of the track (see plates XV. and XIX.). The second variety (E, fig. 50) is less common; in it two of the main limbs of the simple stellate figure are suppressed, while the remaining two form a continuous line from one margin of the shaft to the other, the point of impact lying approximately in the centre of the line of fracture. Suc
PREV.   NEXT  
|<   142   143   144   145   146   147   148   149   150   151   152   153   154   155   156   157   158   159   160   161   162   163   164   165   166  
167   168   169   170   171   172   173   174   175   176   177   178   179   180   181   182   183   184   185   186   187   188   189   190   191   >>   >|  



Top keywords:

fractures

 

bullet

 

impact

 
fracture
 

margin

 

direction

 

passing

 
strongly
 

marked

 

stellate


variety

 

comminuted

 
common
 

secondary

 

fissures

 
struck
 

oblique

 

perforation

 

varieties

 

groove


opening
 

illustration

 
perforations
 

portion

 

depicted

 

centre

 

notched

 

approximate

 
approximately
 

carried


Oblique
 

degree

 

alluded

 

proximal

 
plates
 

suppressed

 

grooving

 

considerably

 
remaining
 

Notching


naturally

 

cancellous

 

portions

 

figure

 
simple
 

continuous

 

fissure

 

lateral

 
radiating
 

illustrates