Since nearly every case of gunshot fracture of the bones of the extremities is compound and infected, there arises in practically every instance the important question whether or not one should strive in the presence of infection, perhaps taking the form of active phlegmon, to secure coaptation and provide extension.
Four measures, as stated by Rydigier von Ruediger, are of indisputable value: (1) reposition, brought about in the most gentle and cautious manner; (2) the most precise and uninterrupted immobilization not disturbed during the change of dressings; (3) a supportive apparatus, allowing free access to the wound; (4) a supportive apparatus, the making and use of which requires the least technical skill and experience.
It is established that many gunshot wounds of the soft parts, even in soldiers coming from the necessarily insanitary trenches, heal by first intention, as Simon and Pirogoff have stated. In the case of gunshot wounds
EASTMAN JR. GUNSHOT FRACTURES OF THE SHAFT OF THE HUMERUS. JAMA. 1917;LXIX(4):251-256. doi:10.1001/jama.1917.02590310003002