leg than in any other part of the body, and this often
without solution of continuity of the bones, and sometimes without
evidence even of contact of the bullet with either tibia or fibula. Some
remarks on this subject have already been made in the chapter on wounds
in general, and some sources of fallacy exposed. I believe that in
practically all these so-called explosive injuries the wound was either
caused by a ricochet, or a bullet which deformed with great ease on bony
contact during its progress through the limb. A considerable number of
the wounds which were referred by the men to the use of expanding
bullets were probably the result of the use of Martini-Henry or large
leaden sporting bullets, and evidence of this was often forthcoming on
examination of the entry wounds. In other cases the irregularity of the
opening plainly pointed to ricochet of a small bullet as the explanation
of the character of the injury. The greater frequency of ricochet
injuries in the leg and foot when the men were standing is readily
understood.

Concurrent injury to the vessels of the leg was common, but primary
haemorrhage, as was the case generally, usually ceased spontaneously. The
importance of injury to the vessels was rather in view of secondary
haemorrhage, which occurred with some frequency, and I think more
commonly from the anterior than the posterior tibial vessels, usually
occurring at the end of a week or ten days, and naturally most
frequently in cases which suppurated.

_Prognosis and treatment in fractures of the leg._--In fractures of the
leg, except those of extreme severity, almost any form of splint
sufficed to maintain the bones in position, but for field purposes the
Dutch cane splint (fig. 58, p. 222) was certainly very convenient. For
later use in cases that needed frequent dressing, a wooden back splint,
with a foot-piece, or, if obtainable, a Neville's splint with a
suspension cradle, was the best. Where the wounds were small and
frequent dressing was not required, nothing was so good as plaster of
Paris, especially when transport was a necessity.

[Illustration: FIG. 58.--Dutch Cane Field Emergency Splint for Leg]

In cases with large wounds suppuration was very frequent, and in
connection with this secondary haemorrhage, or in the case of fractures
near the articular ends, especially the upper, joint suppuration. The
treatment of these cases varied: in many an amputation was the best or
only treatment