Gunshot injuries : how they are inflicted : their complications and treatment . rubbedwith soap and water and the wound thoroughly irrigated with bichlo-ride of mercury 1-2000. Detached spicula of bone should be re-moved, drainage provided for, and after the application of a cleandressing the hand and forearm up to the elbow should be immo-bilized. If sepsis sets in, the continuous arm bath will be of greatservice; and if suppuration is impending free incisions and thoroughdrainage should be practised early. In extensive comminution of GUNSHOT INJURIES OF THE DIAPHYSES OF THE LONG BONES 389 th
Gunshot injuries : how they are inflicted : their complications and treatment . rubbedwith soap and water and the wound thoroughly irrigated with bichlo-ride of mercury 1-2000. Detached spicula of bone should be re-moved, drainage provided for, and after the application of a cleandressing the hand and forearm up to the elbow should be immo-bilized. If sepsis sets in, the continuous arm bath will be of greatservice; and if suppuration is impending free incisions and thoroughdrainage should be practised early. In extensive comminution of GUNSHOT INJURIES OF THE DIAPHYSES OF THE LONG BONES 389 the phalanges and metacarpal bones the surgeon should make everyeffort to preserve as much of the injured part as may be consistentwith even a partial degree of utility. The advantage of preservingone or more fingers, as, for instance, the thumb and one finger or theindex finger alone, is of great value. Gunshot Injuries of the Shaft of the Femur.—There were 6738shot injuries of the femur in our Civil War, of which 162 were classedas contusions and 6576 as gunshot Fig. 146.—A recent skiagram showing lodged conoidal bullet against bone in old soldier woundedin Civil War, 1861-65. Reported by George DeShon, Med. Corps, U. S. Army. Armyand Navy Genl. Hospital, Hot Springs, Ark. X-ray Laboratory. Shot Contusion of the Shaft of the Femur.—The contusions ofthe femur from gunshots were more frequent than those of the humerusalready referred to. Otis records that amputation became necessaryin nine instances with seven fatal results, a mortality of per cent.,while the remainder 153 were treated conservatively without operationwith a mortality of per cent. (Figs. 145 and 146). There is no reference to contusion from gunshots of bone in recentwars. The lesion is evidently more rare with the new armament, orthe present method of wound treatment, which tends to keep wounds 390 GUNSHOT WOUNDS aseptic, does away with the inflammatory complications that forme
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