As a rule the infected cases of this class recovered without loss of limb. Amputation was very rare. [Illustration: Plate 56.] RIFLE--PLATE 56. LOWER EXTREMITY. Gunshot Fracture Below the Middle of the Femur, with Lodgment of the Bullet Near the Fracture. The course of the projectile was transverse. The long splitting fracture, with few large fragments and the lodged undeformed missile, indicate that the injury to the bone was caused by the missile striking the bone with large cross section or at an inclined angle so that all of the remaining energy of the projectile at long range was absorbed by the bone. Had the point of the ball struck the bone with the same energy, it would have produced smaller fragments and might then have passed beyond the bone. The normal size of the diameter, slightly shortened length, greater density of the point of the shadow, shows the bullet to lie behind the bone with its nose pointing slightly backward. The actual length of the bullet is 1.25 inches: the length of the shadow is 1 inch. Treatment and results would be about the same as in plates 49 and 50. [Illustration: Plate 57.] RIFLE--PLATE 57. LOWER EXTREMITY. Gunshot Fracture About the Middle of the Femur, with Lodgment of the Fragments of a Deformed Bullet. The course of the missile was transverse. All of the remaining energy of the retarded velocity of the short range of a ricochet shot was stopped by the bone with the result of a long splitting fracture, and the lodgment of one large and a few small fragments of the missile. The small notched metal fragment lying to the right of the upper bone fragment is a small bent piece of the jacket, detached from the greatly deformed lead core, which can be faintly seen lying behind the lower end of the left side of the upper bone fragment. The treatment is extension with lateral compression, although this case, showing by callus formation advancing convalescence, reveals very bad position. Results as to life and limb are favorable in such cases, but some deformity is to be expected. It should be noted that this is a case from Gulhané Hospital, the best military hospital in Constantinople, where the surgical service, under Prof. Wieting Pasha, was skillfully conducted. [Illustration: Plate 58.] RIFLE--PLATE 58. LOWER EXTREMITY. Gunshot Fracture of the Lower End of the Femur. The course of the bullet was anteroposterior. The long, oblique, splitting fracture without separate fragments indicates the long range of the missile in low velocity. The wound was infected as is indicated by the drainage tubes in place. The well-advanced callus formation indicates established convalescence. Results are favorable for recovery with only fair position and some shortening. It may be observed that this is also a case from Gulhané Hospital. [Illustration: Plate 59.] RIFLE--PLATE 59. LOWER EXTREMITY. Gunshot Wound of the Left Knee-Joint, with Lodgment of the Missile in the Joint.