The olecranon process of the right ulna rests on the photographic plate, with the forearm in semipronation, so that the shadow of the radius falls nearly in line with that of the ulna. With the forearm restored to the anatomical position, the spattered metallic fragments, now seen lying over and to the left of the radius, would then be shown lying on the outer border of and posterior to the radius, except for the upper right metallic fragment, now lying over the ulna, which would be seen lying over the anterior surface of the radius. The six pellets seen in the lower forearm have not contributed to the injury of the bone. Their density and indefinite outline indicate a position in the forearm opposite to the side next to the plate. With the forearm in supination they would appear in their real position, in front of the ulna and on the outside of the radius.
The missile in its course from behind forward and from above downward left a trail of its metal particles along the line of its first contact until the bone yielded to the pressure in a transverse fracture.
The arm lies in slight pronation with the longitudinal ridges of the dorsal surface of the ulna, shown distinctly next to the photographic plate. The upper end of the lower radial fragment, shown as overlying the ulna, is inclined forward in the anatomical position. The metal particles are on the outer and posterior border of the radius.
The treatment in such cases is conservative.
The course of the missile was tangential along side of the upper end of the ulna and internal condyle of the humerus, with a splitting effect on the ulna, which formed three fragments by breaking off the olecranon, and one lateral fragment from the shaft of the bone without displacement. The line of metallic particles shows the path of the ball in its slight contact with the bones, beginning on the side of the ulna and extending along the side of the internal condyle from where the ball escaped through the skin. The wound, not infected, was treated as simple fracture. A few fine lines on the plate above the fracture are due to scratches on the negative.
Gunshot Fracture of the Right Metacarpus.
The course of the missile was from the outer border of the hypothnear eminence diagonally downward through the palm, lodging against the second metacarpal bone with fracture of last four metacarpals.