Wounds in war : the mechanism of their production and their treatment . Fig. 70. Gunshot fracture of skull; part of the bullet was found within the cranium,and part under the scalp, as shown here.—Netley Museum. such cases are not likely to result from the hard-mantledsmall-bore bullets. Grooving of the external table and diploe were fre-quently produced by the old leaden bullets striking tangen-tially ; this class of injury to the skull is equally probablewith the new bullet, and, as in other cases, the injury tothe inner table is likely to be of greater extent than thatof the outer. Depresse
Wounds in war : the mechanism of their production and their treatment . Fig. 70. Gunshot fracture of skull; part of the bullet was found within the cranium,and part under the scalp, as shown here.—Netley Museum. such cases are not likely to result from the hard-mantledsmall-bore bullets. Grooving of the external table and diploe were fre-quently produced by the old leaden bullets striking tangen-tially ; this class of injury to the skull is equally probablewith the new bullet, and, as in other cases, the injury tothe inner table is likely to be of greater extent than thatof the outer. Depressed fractures of both tables are very common(fig. 72). They are usually the results of shell fragments, PENETRATION OE THE SKULL 265 or of small-arm bullets at low rates of velocity. Thedepression is usually cup or cone shaped, with fissuresextending from the edge of the cup to the centre of thedepression, dividing the plate of bone into two or moretriangular fragments. The comminution accompanyingthese fractures may be very severe, and fissures may. Fig. 71. The bullet was found within the cranium, but the aperture in theskull had almost closed.—Netley Museum. radiate from them for long distances ; the use of thetrephine is always indicated in this class of case. Small-arm bullets travelling at high and medium velo-cities, and striking more or less perpendicularly to thesurface, cause penetration or complete perforation of theskull. The entrance apertures in these cases are clean-cutand punched-out circular holes ; while the exit aperture,when perforation takes place, is more splintered andirregular, from increased fracture of the outer table. Theouter table at the entrance side is cleanly pierced and 266 WOUNDS IN WAR circular ; while the inner table (fig. 73) is splintered, morelargely fractured, and spiculae are driven into the dura mater
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