In this case the location of the shrapnel ball would furnish unquestioned evidence; or, if a shrapnel ball had produced this particular bone destruction, its path among the fragments would have been marked by traces of lead. Two metal fragments indicate that the lead core of the bullet was exposed. The wound, not infected, was treated expectantly. Result in such cases is favorable. [Illustration: Plate 12.] RIFLE--PLATE 12. UPPER EXTREMITY. Gunshot Fracture of the Humerus. The course of the missile was anteroposterior through the middle of the arm. The ballistic conditions and lines of force applied to the bone were somewhat, if not entirely, similar to those producing the fracture shown in plate 11. The missile struck the wall of the shaft without passing through the medullary canal, but a secondary fragmentation of the two large fragments did not follow except for the breaking of the tip of the distal fragment. The range was long. There was little deformity and no infection. Plaster dressing was applied and the slight outline of callus formation indicates the process of repair. The lack of contrast in the shadow of the bone is due to the opacity of the plaster dressing through which the Roentgen exposure was made. Treatment in such cases is expectant. Results should be uniformly good. [Illustration: Plate 13.] RIFLE--PLATE 13. UPPER EXTREMITY. Gunshot Fracture of the Right Humerus, with Lodgment of the Missile. Wound of entrance, about middle of the anteriorinternal aspect of the arm. Wound of exit, none. The course of the missile was from without, downward and inward to a point of lodgment above the internal condyle. The distinct outline and normal size of the base of the bullet shows it to be near the plate, with the internal condyle next to the plate in the exposure. The bullet mushroomed when it struck the bone with a “soft nose,” in which the lead was not protected by a tough metal jacket. It may have been dum-dummed; it is remotely possible that the nose of the jacket was split by ricochet, or it is more probable that it was of the unjacketed variety. The effect is identical with that of a shrapnel ball, striking with its normal low velocity, which is about the same as that of the missile in this wound. The invariable characteristic of a shrapnel wound of a bone, namely, the small particles of metal marking its course in contact with the bone, is seen in this plate. The treatment in such cases is expectant, with due regard to the character of the infection, and without primary search for the missile. The results are generally favorable. [Illustration: Plate 14.] RIFLE--PLATE 14. UPPER EXTREMITY. Gunshot Fracture of the Humerus, with Lodgment of the Missile.