Surgical Experiences in South Africa, 1899-1900: Being Mainly a Clinical Study of the Nature and Effects of Injuries Produced by Bullets of Small CalibreMakins, George Henry
History
Surgical Experiences in South Africa, 1899-1900: Being Mainly a Clinical Study of the Nature and Effects of Injuries Produced by Bullets of Small Calibre
Makins, George Henry
Gunshot wounds; South African War, 1899-1902; Surgery, Military
The large median fragment carried forwards, and the small degree of
comminution, suggest the decrease of resistance and prolongation of
impact by carriage back of the arm when struck.
The fracture is one of the nearest approaches to a transverse cleft that
I met with.
The plate may well be compared with No. XII., where the effect of
increased resistance in augmenting the degree of comminution is seen.]
Lesser degrees of the same kind of injury amounting to grooving of the
surface or notching of the crest of the ilium were not uncommon, and the
occasional large character of exit openings in buttock wounds pointed to
contact of travelling bullets with other parts of the external pelvic
wall.
[Illustration: FIG. 55.--Clean Gutter Fracture of the Ilium (range
placed by patient at 300 yards. Highland Brigade, Magersfontein). The
gutter was clean cut, and admitted the forefinger. The inner and outer
tables of the bone were in part blown out of a large irregularly
circular exit opening about 1-1/2 in. above the crest of the ilium. The
cancellous tissue was probably entirely blown out. Plates of the outer
and inner tables still remained connected by their periosteum to the
deep aspects of the iliacus and gluteus medius muscles. The peritoneal
cavity was not opened. The patient did well. Compare with the gutter
fractures of the skull shown in figs. 64, 66.]
Certain portions of the pelvis were subject to more severe comminution;
thus in one case in which the bladder was wounded, a very much
comminuted fracture of the horizontal ramus of the pubes was produced by
a bullet which subsequently lodged in the thigh behind the femoral
vessels. In this case the track was so oblique as to have necessitated
almost pure lateral impact on the part of the bullet; hence the form of
injury was nearly allied to the comminutions of the ilium already
described.
[Illustration: PLATE X.
Skiagram by H. CATLING
Engraved and Printed by Bale and Danielsson, Ltd
(29) Wedge-shaped Fracture of the Radius
Range 'a few yards.'
The officer shot the man, his assailant, with a revolver. The entry
wound was on the posterior aspect of the forearm at the junction of the
middle and lower thirds. The exit wound was on the anterior aspect of
the forearm, 1 inch below the elbow crease, and of moderate size.
Some fine fragmentation of the mantle of the bullet is indicated, and
very fine comminution of the bone. The fracture healed well, but the
resulting mass of callus at the end of three months prevented any
movements of pronation or supination.]
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