The course of the bullet was diagonally anteroposterior from within outward, striking the posterior border of the upper end of the ulna and passing through the head of the radius, carrying the fragments of the latter before it and lacerating the wound of exit. The energy of impact also fissured the upper end of the shaft of the ulna and fractured the neck of the radius without detaching the large fragments. This is the effect of a rifle bullet at short range, or possibly a ricochet shot at mid range. The emergency treatment is antiseptic dressing with splint immobilization. The subsequent treatment is conservative, whether the wound is clean or infected. The course of treatment of such an infected wound might extend from four to six months. NOTE.--As the soldier always escapes the burden of explanation when the wound of entrance is anterior rather than posterior, it should be remembered that the forearm may occupy positions in relation to the body which exposes the anatomically posterior aspect of the forearm to missiles directed toward the anterior surface of the body; and as the wounds of the forearm herein presented are described in the anatomical position, there is no justifiable impeachment of the soldier’s valor in an inference that he was shot from behind when the wound of entrance involves the posterior aspect of the forearm. [Illustration: Plate 21.] RIFLE--PLATE 21. UPPER EXTREMITY. Gunshot Fracture of the Radius and Ulna. The course of the bullet at short range was transverse through both of the bones, with a splitting effect and without much small fragmentation. The wound of exit in this case was slightly lacerated, but not very much larger than the wound of entrance. The treatment should be conservative. Emergency treatment should not include exploration, and nothing but the conventional iodine dressing and splints should be applied. [Illustration: Plate 22.] RIFLE--PLATE 22. UPPER EXTREMITY. Gunshot Fracture of the Radius and Ulna. The course of the bullet at short range was transverse through the upper forearm, striking the radius in the center of the shaft and the ulna nearer the border. Several small fragments followed the course of the bullet, but did not emerge with it at the wound of exit to cause a laceration. The capitellum was next to the photographic plate and the angular line of the radius can be seen crossing the straighter line of the ulna. Further information is obtained from the examination of another view, plate 23, made of the same subject. [Illustration: Plate 23.] RIFLE--PLATE 23. UPPER EXTREMITY. Gunshot Fracture of the Radius and Ulna. This plate was made from the wound shown in plate 22, with the arm in greater inward rotation. This position shows the wide separation of the large fragments of the radius.