Emergency treatment in such cases is antiseptic dressing only, without exploration, and with fixation by splints for transportation. The degree of infection determines the subsequent course of conservative treatment, with operative methods for correction of deformity reserved for further stage of convalescence and for best surgical facilities. [Illustration: Plate 24.] RIFLE--PLATE 24. UPPER EXTREMITY. Gunshot Fracture of the Radius and Ulna in the Upper Third of the Forearm. The course of the projectile was from within, outward and diagonally forward, with a direct impact on the ulna, and a tangential impact on the radius, with several lines of splitting fracture in the latter without detaching fragments. Particles of metal, spattered around the point of first impact, were deposited by the lead core of a bullet, exposed by a torn jacket, which struck the second bone with its jacketed surface. The treatment is always conservative--meeting indications in case of infection. Results are good for saving the limb, but not for avoiding deformity. [Illustration: Plate 25.] RIFLE--PLATE 25. UPPER EXTREMITY. Gunshot Fracture of the Radius. Wound of entrance, posterior surface of forearm over radius above the middle. Wound of exit, below and in front of wound of entrance. The course of the ball in mid range was from behind, forward, and slightly downward. While the images of both bones of the forearm are superimposed, because they both lay in the plane of the projection of the shadow, it is probable that the radius lay nearer the photographic plate, because the head of the radius is shown in clearer outline. The fragments of the fracture can be seen as related to the outlines of the radius. There is no displacement and only slight fragmentation, so that the bullet must have almost succeeded in making a punctured wound in the radius. The treatment in such cases is regularly that for simple fracture, as such wounds are almost always aseptic. The results are uniformly good. [Illustration: Plate 26.] RIFLE--PLATE 26. UPPER EXTREMITY. Gunshot Fracture of the Radius. Wound of entrance, midway between radius and ulna and midway between elbow and wrist, anterior aspect of the forearm. Wound of exit, over radius at point opposite. The course of the bullet, in the medium velocity of mid range, in piercing the medullary canal has almost succeeded in drilling the bone without splitting off several longitudinal fragments. Small fragments followed the course of the missile, without being energized sufficiently to lacerate the point of exit by escaping with the projectile. The wound of exit in such cases hardly differs enough from the wound of entrance to be distinguishable. This condition so often obtains that the great majority of perforating rifle wounds of the forearm do not show the blow-out or “explosive” effect which seems to be generally misunderstood as a classic accompaniment.