As the heel lay on the plate, the projectile at a sharp angle with the plane of the plate, several inches farther from the plate than in the preceding radiograph, and with the line of projection at about right angles to the long axis of the projectile, the shadow projection is considerably enlarged. [Illustration: Plate 75.] SHRAPNEL--PLATE 75. HEAD. Gunshot Fracture of the Vertex, with Intracranial Lodgment of the Missile. Wound of entrance, left anterior parietal region. Wound of exit, none. The missile left a few small fragments spattered on the bone at point of entrance, with a slight deformation of the ball due to this cause, as shown in the plate. The distinct outline and normal size of the ball shows it to be very near the plate and on the left side of the head, while the enlarged and blurred image of the safety pin shows its position to be on the side of the head farther away from the plate. Emergency treatment is antiseptic dressing only. Subsequent treatment is directed to fragments and depression, without search for ball. Septic condition might indicate some later interference. Results in such cases are favorable if wound is not infected. [Illustration: Plate 76.] SHRAPNEL--PLATE 76. HEAD. Gunshot Fracture of the Vertex. Wound of entrance, upper right and mid-parietal region. Wound of exit, none. The missile probably was deformed before striking the skull, upon which it was fragmented by impact, with several fragments following the internal contour of the vertex and others remaining spattered about the wound of entrance. It is probable that a larger mass of the shrapnel ball, causing the greater damage to the bone, ricocheted out of the wound. The distinct outline of the central safety pin and the less definite image of the shrapnel fragments show the wound to have been farther from the plate than the safety pin on the left side. The treatment is expectant, without search for the missile. Results in such cases are favorable, except for danger of infection. [Illustration: Plate 77.] SHRAPNEL--PLATE 77. HEAD. Gunshot Fracture of Zygoma, with Lodgment of the Missile in the Zygomatic Fossa. Wound of entrance, external border of right supra-orbital ridge. Wound of exit, none. A few metallic fragments are seen where the missile lodged near the point of impact with the bone. The treatment is expectant. Removal of the ball from its superficial location is indicated if the wound is infected. Result in such cases is favorable. [Illustration: Plate 78.] SHRAPNEL--PLATE 78. HEAD. Gunshot Fracture of the Mastoid Process. Wound of entrance, upper posterior cheek, in front of the ear. Wound of exit, posterior to mastoid process, lacerated. The course of the missile was tangential, with the damage limited to the outer table of the mastoid. The metal particles scraped off of the ball by its contact with the bone mark the site of the wound. Treatment is expectant. Results are favorable.