Gunshot injuries, their history, characteristic features, complications, and general treatment : with statistics concerning them as they have been met with in warfare / by Sir T. Longmore.

Date:: 1895

Credit: Gunshot injuries, their history, characteristic features, complications, and general treatment : with statistics concerning them as they have been met with in warfare / by Sir T. Longmore. Source: Wellcome Collection.

Provider: This material has been provided by the Royal College of Physicians of Edinburgh. The original may be consulted at the Royal College of Physicians of Edinburgh.

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$humerus to snap across near the old site of injury. A private of the 42nd Regiment also had his humerus fractured by a shot in the same action. The missile in this case came from one of the old smooth-bore muskets used by the natives, and the fracture was of a trifling nature compared with that sustained by the officer previously mentioned. The broken bone was quickly united, and seemed to be quite strong when the man landed in England in April of the same year. On the 18th of June he had a struggle with a prisoner, when re-fracture of the bone occurred at the former place of injury. A private of the 10th Regiment was wounded in action at Perak in the Malay Peninsula, on the 7th of November 1875. The right humerus was fractured. He returned to England in March 1876 with the bone apparently firmly united, but with the elbow, wrist, and finger joints almost com- pletely anchylosed. In October 1876 an attempt was made to reduce the anchylosis of the elbow under chloroform, and while pressure was being made to bend the elbow, the humerus gave way and became broken again near the original wound. The re-fracture in these instances did not interfere in any way with a repetition of union. Bones which have become firmly consolidated after gunshot comminuted fracture, and even in cases in which full power has seemed to have been restored, and in which the wounds in the soft parts have remained sound for years, are still liable to elimi- nation of sequestra when detached splinters have been locked up in the new bone at the site of injury. I have elsewhere referred to the case of an officer who was under my care in the Crimea for a gunshot fracture of the thigh-bone in the upper third of the femur, who, though he had been on active duty and quite well for a period of nearly eleven years, suddenly at the end of that time became the subject of tenderness, without any external exciting cause, near the scar at the spot where the bullet had entered. The soreness increased, was followed by a small abscess, and from this abscess, when opened, a small sequestrum, one inch in length, evidently one of the original splinters, was extracted.4 The wound of escape healed as soon as the piece of bone was got rid of, and no further trouble has been since experienced. Many examples of splinters locked up in the copious irregularly shaped new bone, by which some of the specimens of gunshot fractures have been united, are to be seen in the Museum at Netley. An examination of them will sufficiently show that such of them as by their form and situation were evidently completely detached at the time of the original injury are entirely necrosed; while others which had probably retained some amount of periosteal connection are also partially necrosed to a greater or less extent. As long as such fragments remain locked up in the new bony material, so long must the patient be liable to accidents connected$