The course of the bullet was transverse, entering the capsule posterior to the patella without injury to the bone. As its shadow projection is almost circular, the bullet must be standing almost on its end pointing toward the plate with its long axis almost parallel to the line of projection. As the fibular side of the leg lay next to the plate and as the only slightly enlarged shadow of the bullet indicates it to be near the plate, its position is in the joint near the fibular side. As the bullet is undeformed and its penetrating power very slight, its velocity was that of extreme range. The emergency treatment, is, of course, a simple antiseptic dressing with the leg held in the most comfortable position by muscular action. The subsequent treatment is removal of the bullet when proper surgical conditions obtain. [Illustration: Plate 60.] RIFLE--PLATE 60. LOWER EXTREMITY. Gunshot Fracture of the Tibia and Fibula, with Lodgment of the Missile. The course of the bullet was diagonal from within outward and backward about the middle of the leg, with the impact tangential on the tibia and direct on the fibula. The bullet lies just behind the tibia. It is apparent that the bullet has been greatly deformed and that its jacket has been badly torn from the core. The force of impact on the object from which it ricocheted must have been contributed by the velocity of short range, which reduced the striking energy so greatly that the bullet was lodged by the resistance of the tibia and fibula. The wound was not infected, and callus formation shows that repair has begun. The treatment in such cases, without infection, is noninterference. The lodgment of the missile need not prejudicate the prognosis, and certainly the additional damage in the search for the bullet is not warranted, except under special indications. [Illustration: Plate 61.] RIFLE--PLATE 61. LOWER EXTREMITY. Gunshot Fracture of the Lower Ends of the Tibia and Fibula. The course of the bullet was transverse, with the velocity of mid-range. The fragmentation of the fibula, lying close to the skin, would produce considerable laceration in the wound of exit. The treatment is conservative. Infection would depend almost entirely upon the integrity of the first dressings and immobilization. Results should be favorable, with care in subsequent treatment. [Illustration: Plate 62]. RIFLE--PLATE 62. LOWER EXTREMITY. Gunshot Fracture of the Upper Third of the Tibia, with Large Longitudinal Fragment. The course of the bullet was anteroposterior and slightly diagonal from without inward through the shaft of the tibia. The injury was due to the energy of impact of a bullet, in the high velocity of short range, striking the axis of the diaphysis, in which the greater part of its energy was expended in pushing away a wall of the canal. Convalescence is well established without infection, as shown by callus formation.