The slight penetration of the missile and its normal character show that, having struck no intervening object, it indicted the wound at extreme range.
The treatment should meet the indication for removal of missiles in all superficial or easily accessible locations and when they cause reaction.
Results to be expected are favorable except for loss of the eye.
Gunshot Fracture of the Ramus of the Lower Jaw.
Wound of entrance, in the cheek behind the angle of the mouth.
Wound of exit, below the tip of the mastoid.
The course of the bullet was almost tangential to the ramus of the jaw, anteroposteriorly. The slight fragmentation, which is hardly more than a splitting of the bone, with little or no displacement, indicates that the wound was made by a rifle bullet at moderate velocity and at mid or long range.
Gunshot Fracture of the Ramus of the Lower Jaw.
Wound of entrance, over the anterior border of the right ramus.
Wound of exit, beneath the lobe of the ear.
The wound was made by a rifle bullet with the velocity of long range, because wounds of a shrapnel ball never show such slight injury without lodgment or without marks of lead.
The damage of the bone was very slight, as only a superficial fragment was chipped off. There were no signs of primary infection. Reaction and periostitis suggested the radiograph after infection had rarefied the fragment, shown but very faintly on the left side of the plate.
The postero-anterior skull radiograph was made with the face superimposed upon the photographic plate.
Gunshot Fracture of the Body of Lower Jaw, with Great Fragmentation and Displacement.
Wound of entrance, to the left side of the median line of the lower jaw below the alveolar process, with course ranging downward and backward.
Wound of exit, with extensive laceration, beneath lower border of the bone.
The wound was caused by a rifle bullet at high velocity at or less than mid range. The fragments are many and rather small, so that much bone was lost through the wound of exit. This effect was produced by the splitting due to the relative friability of the bone and to the imparting of the momentum of the missile to the detached fragments, which, together with the missile, effected the considerable laceration of the wound of exit.