Clyde S. Ford

“ 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. ”

“ The considerable striking energy retained in a small portion of the mass—consisting of only the nose and a little more of the jacket of the bullet, but sufficient to fragment a large section of the bone, and then to traverse more than half the length of the forearm—leaves no doubt that the shot was fired at very close range, and that the bullet was broken on a nearly resisting surface, leaving in the nose of the bullet a striking force equal to that of the entire projectile at long range. ”

“ The hard metal jacket of a rifle bullet would not give off its particles in contact with the bone unless it were so greatly deformed as to have almost entirely lost its jacket. In this state the energy of a rifle ball must be so greatly reduced, through the violence of ricochet, that it would not retain enough striking force to cause its disintegration on impact with the bone. ”

“ By the metallic path of the missile it is known that its soft metal mass was not protected by a hard metal jacket; by the slight damage done to the bone, which lay directly in its path, its velocity and consequent energy are revealed as very slight; by the absence of larger metallic fragments it is shown that the missile was not deformed nor robbed of its energy through ricochet; and as only these conditions can be furnished by a lead ball, undeformed and traveling at low velocity, the missile was a shrapnel ball. ”

“ The wound of exit in such cases hardly differs enough from the wound of entrance to be distinguishable. This condition so often obtains that the great majority of perforating rifle wounds of the forearm do not show the blow-out or “explosive” effect which seems to be generally misunderstood as a classic accompaniment.
The bullet was traveling at high velocity of perhaps less than mid range.
The treatment is usually that of a simple fracture, and warrants no interference except in case of occasional infection.
Results are almost always good. ”

“ This fact is all the more emphasized in the present world war, in which the rifle fire is employed principally in trench warfare at near-by ranges, and where all the wounds which involve the resistant structures of the body show the characteristic features usually described as those of explosive effects. ”

“ Note.—As the soldier always escapes the burden of explanation when the wound of entrance is anterior rather than posterior, it should be remembered that the forearm may occupy positions in relation to the body which exposes the anatomically posterior aspect of the forearm to missiles directed toward the anterior surface of the body ”

“ The destructive lesion to be expected from a given shot at a given range against a certain resistant structure can not be depended upon to occur as it will when the shot is made with scientific accuracy in the shooting gallery against cadavers. ”

“ Emergency treatment in all such cases is antiseptic dressing without exploration or manipulation of fragments, and with splint immobilization.
Results are unfavorable as to function, depending upon extent of destruction of tendons. ”

“ They are derived (1) from the Turkish pointed bullet weighing approximately 15.0 grams—it is fired from the German Mauser and has all the ballistic values of the projectile from this weapon; (2) the Bulgarian bullet, blunt nosed or ogival headed and the same as the steel-jacketed bullet of the Austrian Mannlicher; (3) shrapnel balls and fragments of the shrapnel, and (4) fragments of steel shells from field artillery.
During the evolution of reduced caliber rifles experiments were made on cadavers at different ranges. ”