mpact on the part of the bullet; hence the form of
injury was nearly allied to the comminutions of the ilium already
described.

[Illustration: PLATE X.

Skiagram by H. CATLING

Engraved and Printed by Bale and Danielsson, Ltd

(29) Wedge-shaped Fracture of the Radius

Range 'a few yards.'

The officer shot the man, his assailant, with a revolver. The entry
wound was on the posterior aspect of the forearm at the junction of the
middle and lower thirds. The exit wound was on the anterior aspect of
the forearm, 1 inch below the elbow crease, and of moderate size.

Some fine fragmentation of the mantle of the bullet is indicated, and
very fine comminution of the bone. The fracture healed well, but the
resulting mass of callus at the end of three months prevented any
movements of pronation or supination.]

I never observed a fracture of the floor of the acetabulum by a bullet
which had entered from the back of the pelvis, although tracks entering
by the great sciatic notch were not infrequent. I saw one case in which
a bullet which traversed the upper part of the shoulder and emerged at
the axilla entered a second time an inch behind and above the anterior
superior spine, and split off a layer of the outer table of the ilium of
the extent of two square inches, which involved the upper portion of the
rim of the acetabulum. No displacement upwards of the femur resulted;
but external rotation was accompanied by crepitus. The wound suppurated,
and some general infection resulted, but six weeks later there was no
evidence of fluid in the hip-joint, the limb was adducted and slightly
rotated outwards, and some movement in each direction could be made
without causing any great amount of pain. I can say nothing of the
further course of this case, as I neglected to take the patient's name.

I saw one or two instances of perforation of the sacrum. One is
mentioned in the chapter on injuries to the abdomen, in which a central
puncture at the level of the fourth vertebra was accompanied by
temporary incontinence of faeces.

Fractures of the _femur_ were fairly numerous and formed one of the most
serious classes of case we had to treat, as well as one of the most
fertile sources of mortality in the Base hospitals. In spite of the last
observation, however, it is probable that the results in this campaign
will be far better than in any previous war, both as to the smaller
proportion in which amputation was needed and as to re