Gunshot Roentgenograms: A Collection of Roentgenograms Taken in Constantinople During the Turko-Balkan War, 1912-1913, Illustrating Some Gunshot Wounds in the Turkish ArmyFord, Clyde S. (Clyde Sinclair)
History
Gunshot Roentgenograms: A Collection of Roentgenograms Taken in Constantinople During the Turko-Balkan War, 1912-1913, Illustrating Some Gunshot Wounds in the Turkish Army
Ford, Clyde S. (Clyde Sinclair)
Balkan Peninsula -- History -- War of 1912-1913 -- Medical care; Gunshot wounds; X-rays
There is no injury to the bone. The large diameter, shortened length,
and slight density of the shadow show the bullet to be some distance
from and inclining toward the plate and lodged in the muscles behind
the femur, nearer the side away from the photographic plate. It is
difficult to identify the right or left thigh from the radiograph, but
with the history of the wound in the right thigh and the outside of
the leg next to the plate the ball would lie nearer the inside than
the outside of the thigh, nearer the surface behind the femur. As the
shadow shows irregular outline and the location of the bullet low
velocity, the wound was caused by a ricochet shot at very long range.
The treatment is expectant and the course naturally favorable.
[Illustration: Plate 51.]
RIFLE--PLATE 51.
LOWER EXTREMITY.
Gunshot Wound of the Thigh, with Lodgment of the Missile.
As there is no injury to the bone, the bullet is not deformed. Its
penetrating power was not great enough to carry it through the tissue
so it must have struck the leg at extreme range when its energy was
almost spent.
The actual length of the bullet is 1.25 inches; the length of the
shadow is about 1.50 inches.
The increased length and the relatively slight density of the shadow
indicate the bullet to be some distance from the plate. The case
history places the wound in the right thigh, and the posterior surface
of the leg lay next to the photographic plate. As the density of the
shadow is not greater than the thickest portion of the bone, the
bullet probably lies in front of the border of the outer tuberosity of
the femur.
Although the surgeon’s diagnosis had to be made from the only
available plate, there is something of a speculative element in these
deductions, because if the reaction in the knee joint prevented the
patient from extending the leg the increased length of the bullet
shadow could be accounted for by this position, which would permit the
bullet to lie behind the bone and yet far enough from the plate to
account for the shadow enlargement. The nose of the bullet is at the
epiphyseal line, which is shown in the femur.
[Illustration: Plate 52.]
RIFLE--PLATE 52.
LOWER EXTREMITY.
Gunshot Fracture of the Upper Shaft of the Femur.
The course of the bullet was anteroposterior and pierced the axis
of the shaft of the femur with three radiating lines of fracture,
resulting from the perforating action of the bullet striking the bone
at long range and with greatly reduced energy.
This plate shows the lateral separation of large fragments, which is
typical of gunshot wounds of long range.
Such wounds are usually not infected.
Emergency treatment is antiseptic dressing and coaptation with
extension and temporary splint, so that it may support the bone for
transportation and may be easily removable at place of continued
treatment.
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