just below the elbow.
The bullet has cut its way through the inner half of the humerus,
producing little comminution and mere solution of continuity of the bone
without displacement]
_Fractures of the pelvis._--These, as a rule, were of so slight a nature
as to form a very insignificant part of the entire injury with which
they were associated, or when uncomplicated they were of little more
importance than simple wounds of the soft parts. The very great majority
were of the simple perforating type. I had the opportunity of examining
three at the brim of the pelvis, these all passing in a downward
direction. The openings were of about the same calibre as the bullet,
and at their entrance was a small amount of bone dust such as would be
found at the entry hole of a gimlet. It was these that made me consider
the possibility of the rifle grooves having some part in the ease with
which certain perforations are made. Of a large number of cases in which
bullets traversed the ilium, the openings in the bone, as a rule, were
with difficulty palpated. I must say that I was astonished that I never
met with an instance of an extensive stellate fracture in the case of
the ilium. Such may have occurred in some of the cases fatal on the
field or shortly afterwards, but I never came across one in the
hospital. It says much for the combined density and toughness of the
human pelvis.
Comminuted fractures were, however, occasionally met with when the
bullet passed in a track parallel to the plane of the bone. One such of
an unusual character has already been mentioned on p. 171. A still more
interesting form, and one highly characteristic of flat bone injuries,
is shown in fig. 55. The patient, a man wounded at Modder River, was
struck at a range of 300 to 400 yards. The bullet entered over about the
centre of the ilium and emerged in the anterior abdominal wall about 2
inches above the anterior-superior spine. As there was some doubt as to
penetration of the abdomen, and as the exit wound was of considerable
size, the wound was explored, an anaesthetic having been given. A
clean-cut track in the bone was discovered which allowed the middle
finger to be placed in it. There was little splintering of either inner
or outer table of the bone beyond the width of the track, but plates of
each table adhered on the one side to the origin of the gluteus medius,
and on the other to the iliacus, the latter muscle being somewhat widely
separate
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