Gunshot Fracture of the Left Astragalus, with Lodgment of the Missile.
The external border of the foot lay next to the plate, as is shown by the articulation of the cuboid.
A fragment detached from the posterior inferior border of the astragalus and several small metal particles lying behind the fragment are in evidence.
The enlarged shadow of the ball indicates that it does not lie close to the plate, and it must then lie at least as far away as the internal surface of the calcaneus and at a depth from the sole that can be measured on the plate.
The fibular side lay next to the plate, as shown by the shadow of the fibula and the calcaneo-cuboid articulation.
As the metallic particles, showing the path of the missile, appear to be next to the plate, the course of the missile was from the external border of the tendo Achillis diagonally downward and forward, causing only a slight fissure of the calcaneus. A missile, to have done so little damage and to have left a metallic track showing its contact with the bone, must have been unjacketed and of low velocity, and therefore a shrapnel ball.
Gunshot Wound of the Heel, with Lodgment of the Missile.
The tibial side of the foot lay next to the photographic plate.
The normal size, great density, and sharp outline of the shadow of the shrapnel ball show that it lay also close to the plate and about an inch below the inside of the body of the calcaneus. No metallic particles mark the track of the ball in this case, because the course was parallel to the inner surface of the bursa without forceful, or perhaps any, contact with the bursa, and passing through soft tissue, only.
Gunshot Wound of the Heel, with Lodgment of the Missile.
That the inner border of the foot lay next to the plate is shown by the articulation between astragalus, scaphoid, internal cuneiform, and first metatarsal.
The metallic particles show the course of the ball from the posterior calcaneo-astragaloid ligament to below the anterior inferior border of the calcaneus.
As the shadow of the ball is enlarged and the shadow of the fragments blurred, their position is not near the plate and their location is therefore on the external plane of the calcaneus, with the ball lying near the sole.