The treatment in such cases is conservative, with the subsequent removal of the ball from its superficial location. [Illustration: Plate 141.] SHRAPNEL--PLATE 141. LOWER EXTREMITY. Gunshot Fracture of the Left Tibia, with Lodgment of the Missile. The course of the ball was from without and behind, ranging upward and inward, striking the tibia on the outer border, and causing a splitting fracture without displacement of fragments. The missile was most probably deformed by ricochet before it struck the bone, as there is too little bone injury to account for the spattering and wide distribution of the fragments by the direct impact of an undeformed ball. Two metallic fragments lying over the fibula were probably additional missiles detached from the ball as it ricocheted near the wound. The treatment in such cases would be conservative, while meeting the indications of infection. [Illustration: Plate 142.] SHRAPNEL--PLATE 142. LOWER EXTREMITY. Gunshot Fracture of the Left Fibula, with Lodgment of the Missile. This plate furnishes another example of the fragmentation of a shrapnel ball by ricochet on a near-by object before striking the body. A slight fracture of the fibula is seen (at the top of the plate) with the lodgment of multiple missiles over a wide area, without other injury to the bones. The fragments seen through the shadow of the tibia lie nearer the plate than the smaller fragments on the fibula. As the largest fragment, lying below, shows a much enlarged semicircular outline, its position is not close to the plate and it must lie superficially on the inner side of the leg. [Illustration: Plate 143.] SHRAPNEL--PLATE 143. LOWER EXTREMITY. Gunshot Fracture of the Right Fibula. This plate shows the right leg, because the calf always rests on the plate in the absence of a contraindication, which does not occur in this case, and because the slight angle of approach of the tibia and fibula identifies the relation of the lower end of these bones. The nature of the fracture, without much fragmentation and with no displacements of fragments, indicates a slight striking energy of the missile, which was disintegrated by ricochet before striking the bone. The fragments of a shrapnel ball, spattered on a near-by object, struck the leg in front over a wide area, as indicated by the fragments lying over the tibia and smaller ones lying on the inside of the bone. The larger metal fragment, on the fibula, is some distance from the plate, and probably lies in front of the bone, while the smaller ones, seen in sharper outline, lie behind. [Illustration: Plate 144.] SHRAPNEL--PLATE 144. LOWER EXTREMITY. Gunshot Fracture of the Left Fibula. This is another example of the condition, shown in plate 143, in which a shrapnel hall or similar missile is disintegrated by ricochet before a fleeting the wound.