The missile was a fragment of a ricocheted rifle ball, with a part of the lead core carried in a portion of the jacket. The course was from before, backward, striking the humerus in lower third, and leaving particles of lead along its trade. The wound was only slightly infected. Several detached fragments of bone have been removed. The treatment in such cases is conservative, with management of the infection and without formal search for the projectile. The results in such cases are favorable with some shortening of the bone. [Illustration: Plate 15.] RIFLE--PLATE 15. UPPER EXTREMITY. Gunshot Fracture of the External Condyle of the Left Humerus, with Lodgment of the Missile. Wound or entrance, internal and posterior aspect of the arm above the internal condyle. Wound of exit, none. The bullet was greatly deformed by ricochet, with the loss of the greater part or all of its jacket. The line of contact of the unprotected lead with the bone is marked by the same small fragments of lead almost invariably seen in shrapnel wounds. The ballistic conditions in this case are quite similar to those of a shrapnel wound, as the projectile has struck the bone with low velocity. The very slight displacement of a single large fragment from which the missile is slightly withdrawn indicates that the striking energy was relatively low and that the elastic tissues, stretching around the missile at its striking point, contracted after its energy had been expended and then withdrew the missile from its farthest point of advance. The treatment in such cases warrants only the interference suggested by infection and the interference of the missile with function. The results expected are most favorable. [Illustration: Plate 16.] RIFLE--PLATE 16. UPPER EXTREMITY. Gunshot Fracture of the Humerus. The transverse course of the bullet, striking the posterior wall of the shaft without entering the medullary canal, has fractured the bone transversely, with a tendency toward splitting off a large fragment from the distal fragment. The bullet under these ballistic conditions of high velocity and not distant range might have bored its way through the cancellous tissue of the epiphysis of the same bone without any fractures. Gunshot Fracture of the Ulna. The transverse course of the bullet in striking the ulna at high velocity and not distant range has shown a tendency to bore a hole through the bone. A smaller bullet or a larger bone of the same structure might easily have provided conditions to permit this effect. The wounds of exit and entrance in each of these wounds presented almost identically the same appearance. The treatment in such cases is that of a simple fracture, as there is almost always no infection in such wounds. Results are favorable. [Illustration: Plate 17.] RIFLE--PLATE 17. UPPER EXTREMITY. Gunshot Fracture of the Elbow.