SHRAPNEL--PLATE 101. UPPER EXTREMITY. Gunshot Fracture of the Left Radius and Ulna, with Lodgment of the Missile. The course of the missile was from within outward, striking the ulna a glancing blow just above the styloid process, fracturing the anterior surface, and then striking the internal border of the radius and causing a slight notching fracture with a longitudinal fissure. The forearm lies in supination, with its posterior surface next to the plate. As the outline of the missile, as well as of the bone, is blurred, there is not enough differentiation in the shadows to indicate the anterior or posterior location of the missile with reference to the radius. The shrapnel ball struck the bone with low velocity, as all of its remaining energy, absorbed by the two small bones, caused little damage and practically no displacement of fragments. The wound was not infected. The treatment in such cases is, of course, conservative. Results are uniformly good. [Illustration: Plate 102.] SHRAPNEL--PLATE 102. UPPER EXTREMITY. Gunshot Fracture of the Right Radius. A fragmented shrapnel ball, coursing from without inward, struck the upper third of the shaft of the radius and caused a green-stick fracture. A fragment of the ball, larger than those seen in the plate, inflicted the greater damage and escaped through the wound of exit, to be seen below the large fragment on the left of the plate. The olecranon process of the right ulna rests on the photographic plate, with the forearm in semipronation, so that the shadow of the radius falls nearly in line with that of the ulna. With the forearm restored to the anatomical position, the spattered metallic fragments, now seen lying over and to the left of the radius, would then be shown lying on the outer border of and posterior to the radius, except for the upper right metallic fragment, now lying over the ulna, which would be seen lying over the anterior surface of the radius. The six pellets seen in the lower forearm have not contributed to the injury of the bone. Their density and indefinite outline indicate a position in the forearm opposite to the side next to the plate. With the forearm in supination they would appear in their real position, in front of the ulna and on the outside of the radius. [Illustration: Plate 103.] SHRAPNEL--PLATE 103. UPPER EXTREMITY. Gunshot Fracture of the Right Radius. The missile in its course from behind forward and from above downward left a trail of its metal particles along the line of its first contact until the bone yielded to the pressure in a transverse fracture. The arm lies in slight pronation with the longitudinal ridges of the dorsal surface of the ulna, shown distinctly next to the photographic plate. The upper end of the lower radial fragment, shown as overlying the ulna, is inclined forward in the anatomical position. The metal particles are on the outer and posterior border of the radius.