Gunshot injuries : how they are inflicted : their complications and treatment . is near the knee-joint, the immo-bilizing apparatus should invariably include the latter. The following case exhibits the excellent results attainable undermodern conditions: Captain James H. McC, 1st U. S. Vol. Cavalry(Rough Riders), was shot at the battle of Guasimas during theadvance on Santiago, June 25, by a Spanish Mauser bullet. Thebullet entered posteriorly and to the tibial side of the left leg 5 1/2inches above the internal malleolus. It smashed the tibia at this GUNSHOT INJURIES OF THE DIAPHYSES OF THE L
Gunshot injuries : how they are inflicted : their complications and treatment . is near the knee-joint, the immo-bilizing apparatus should invariably include the latter. The following case exhibits the excellent results attainable undermodern conditions: Captain James H. McC, 1st U. S. Vol. Cavalry(Rough Riders), was shot at the battle of Guasimas during theadvance on Santiago, June 25, by a Spanish Mauser bullet. Thebullet entered posteriorly and to the tibial side of the left leg 5 1/2inches above the internal malleolus. It smashed the tibia at this GUNSHOT INJURIES OF THE DIAPHYSES OF THE LONG BONES 399 point badly and fractured the fibula. There were three small woundsof exit on the anterior surface of the leg just below the level of thewound of entrance. The wound was at once dressed with a fielddressing. At noon the next day the writer assisted in operating uponthe case on the hospital ship Olivette. While the patient was underether we found the area of fracture in the tibia marked by the presenceof a number of small pieces of loose bone near the wounds of. Fig. -Radiograms showing postero-anterior and side views in the case ofCaptain James H. McC. exit. The Mauser bullet had separated from its jacket and a numberof pieces of the core and envelope were also removed. The woundwas thoroughly irrigated with a 1-2000 bichloride of mercury solutionand then immobilized. In March, 1913—nearly fifteen years afterthe occurrence—the writer was able to secure a skiagram of leg. There is no deformity in the fibula, and but little de-formity in the tibia. Particles of lead from the core of the bullet arestill embedded in the tissues. There is 3/4-inch shortening and somelimitation of motion in the ankle as a result of injury to the tendoAchillis (Fig. 150). 400 GUNSHOT WOUNDS Without the prompt and radical treatment that was practised inthis case, there would have been long-continued inflammation of thesurrounding tissues, and all the bone lesions th
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