The plate shows, in the wound of entrance, the metal particles deposited by a shrapnel ball which passed out of the sole of the foot without damage to the bone.
The missile carried some small particles of lead, almost wholly detached by a ricochet before striking the foot, which were scraped off as it passed through the skin.
The wound was infected, and radiography was indicated for diagnosis.
The sole of the foot lay next to the plate.
While the very clear, sharp outlines of the metal fragments would seem to show them very near the plate and consequently at the platen side of the tarsus, the foot is not of sufficient thickness to make a very appreciable difference between shadows of such fragments on the dorsal and on the plantar surfaces of the metatarsus. It is very probable that the ball struck the convex, rather than the concave outline of the transverse arch, as the missile has escaped with no fracture of the bones, which would have been very difficult in mechanical accomplishment if its course had been along the convex outline.
There is no fracture of the bones, although a shrapnel ball has passed transversely through the foot, striking the heads of the second and third metatarsals with only slight injury and leaving a few metal particles at points of contact.
Gunshot Wound of the Left Foot by Multiple Missiles, Fracture of the Metatarsus, and Lodgment of the Missile.
The sole of the foot lay next to the plate.
The normal outline of the shadow of the shrapnel ball shows it to lie near the plate or at least beneath the plantar surface of the first metatarsal. The fragments of metal lying near the fourth and fifth metatarsals lie either in the same relation or on the plantar side of the metatarsus. The metallic track leads to the wound of exit of shrapnel ball, other than the one lodged.
Even though the missile has escaped, its identity can be creditably established by the one remaining, which, it is morally certain, was the escaped missile’s companion. These shrapnel particles again demonstrate that the metal deposits seen in other wounds can be identified as particles of lead scraped off from shrapnel balls in the contact of the latter with bones.
OPERATIVE INTERFERENCE IN GUNSHOT WOUNDS.