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  • Epidemiology of Fracture Nonunion in 18 Human Bones

    Abstract Full Text
    online first
    JAMA Surg. 2016; :e162775. doi: 10.1001/jamasurg.2016.2775

    This population-based study uses data from a large health claims database to evaluate the incidence of bone fracture and characteristics that may be associated with nonunion of the fractures.

  • The Effect of Parathyroidectomy on Bone Fracture Risk in Patients With Primary Hyperparathyroidism

    Abstract Full Text
    free access
    Arch Surg. 2006; 141(9):885-891. doi: 10.1001/archsurg.141.9.885
  • Image of the Month—Quiz Case

    Abstract Full Text
    free access
    Arch Surg. 2004; 139(11):1257-1257. doi: 10.1001/archsurg.139.11.1257
  • Philip Syng Physick (1768-1837)

    Abstract Full Text
    Arch Surg. 2001; 136(8):968-968. doi: 10.1001/archsurg.136.8.968
  • Trephination

    Abstract Full Text
    Arch Surg. 2000; 135(9):1119-1119. doi: 10.1001/archsurg.135.9.1119
  • Folk Art Portraiture of Early American Surgeons

    Abstract Full Text
    Arch Surg. 1999; 134(7):782-782. doi: 10.1001/archsurg.134.7.782
  • JAMA Surgery

    Figure: Predictors of Bleeding From Stable Pelvic Fractures

    Figure 2. Pelvic computed tomographic scan of a 79-year-old woman receiving coumadin therapy who presented to the emergency department after a fall. Despite the fact that the plain pelvic radiographs did not identify any tissue, joint, or bone abnormalities, the pelvic computed tomographic scan with intravenous contrast showed a large right pelvic hematoma associated with a small superior pubic ramus fracture (A [arrow] and B). The hematoma displaces the bladder to the left, and multiple foci of contrast extravasation are evident, indicative of active bleeding (C). On the angiogram, the right obturator artery was identified as the culprit bleeding vessel (D) and successfully embolized with an absorable gelatin sponge (Gelfoam) (E).
  • JAMA Surgery

    Figure: The Effect of Parathyroidectomy on Bone Fracture Risk in Patients With Primary Hyperparathyroidism

    Fracture-free survival of 1569 patients with primary hyperparathyroidism in those who have had parathyroidectomy compared with those who have been observed. Parathyroidectomy reduced the risk of fracture. The 10-year fracture-free survival was 73% in those who underwent parathyroidectomy compared with 59% in those who did not (P<.001).
  • JAMA Surgery

    Figure: Lower Extremity Fracture Splints During the Civil War

    John Hodgen's wire suspension device for fractures of the middle and/or lower segment of the femur (author's collection).
  • JAMA Surgery

    Figure: Routine Helical Computed Tomographic Evaluation of the Mediastinum in High-Risk Blunt Trauma Patients

    Widened mediastinum on chest radiography. The computed tomographic scan shows a fracture of the sternum with a retrosternal hematoma. Aortography was avoided.
  • JAMA Surgery

    Figure: Does Uninjured Skin Release Proinflammatory Cytokines Following Trauma and Hemorrhage?

    Proinflammatory cytokine gene expression after soft tissue trauma (A) and closed long-bone fracture (B). Expression of interleukin (IL) 1β, IL-6, tumor necrosis factor α (TNF-α), and S15 rRNA (positive control for RNA quality) was determined using reverse transcriptase–polymerase chain reaction with RNA isolated from injured and uninjured skin (A) or remote, uninjured skin (B). Samples were harvested 1, 2, 4, 8, or 24 hours after injury. The sham control (S) corresponds to 1 hour. The lane at the far right (plus sign) is a positive control indicating molecular weight of the amplified polymerase chain reaction product.
  • Prospective Evaluation of Treatment of Open Fractures: Effect of Time to Irrigation and Debridement

    Abstract Full Text
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    JAMA Surg. 2015; 150(4):332-336. doi: 10.1001/jamasurg.2014.2022

    This prospective analysis showed that time to irrigation and debridement did not affect the development of local infectious complications, provided it was performed within 24 hours of arrival.

  • Association of Mechanism of Injury With Risk for Venous Thromboembolism After Trauma

    Abstract Full Text
    online first
    JAMA Surg. 2016; doi: 10.1001/jamasurg.2016.3116

    This cohort study examines whether a blunt or penetrating mechanism of injury alters the risk of venous thromboembolism.

  • Mapping Population-Level Spatial Access to Essential Surgical Care in Ghana Using Availability of Bellwether Procedures

    Abstract Full Text
    online only
    JAMA Surg. 2016; 151(8):e161239. doi: 10.1001/jamasurg.2016.1239

    This population-based survey assesses the performance of bellwether procedures as a proxy for performing essential surgery, maps population-level spatial access to essential surgery, and identifies first-level referral hospitals that would most improve access to essential surgery if strengthened in Ghana.

  • Reconsidering the Resources Needed for Multiple Casualty Events: Lessons Learned From the Crash of Asiana Airlines Flight 214

    Abstract Full Text
    JAMA Surg. 2016; 151(6):512-517. doi: 10.1001/jamasurg.2015.5107

    This case series discusses the inpatient resources, including imaging, nursing overtime, and blood bank needs, that were used to treat 63 individuals injured in the Asiana Airlines flight 214 crash.

  • Predictors of Bleeding From Stable Pelvic Fractures

    Abstract Full Text
    free access
    Arch Surg. 2011; 146(4):407-411. doi: 10.1001/archsurg.2010.277

    Stable pelvic fractures (SPFs) that do not need operative fixation are only infrequently associated with significant bleeding (SigBleed). Our hypothesis is that simple indicators, easily detectable at the bedside, can alert the clinician about the likelihood of bleeding and the need for closer monitoring or early intervention in patients with SPFs.


    Retrospective review of medical records.


    Academic level 1 trauma center.


    The medical records of patients with SPFs admitted to our academic level 1 trauma center from January 1, 2002, to June 30, 2007, were reviewed. Stable pelvic fractures were defined as fractures not requiring external or internal fixation. SigBleed was defined as the need for blood transfusion and/or intervention for bleeding control within the first 24 hours after admission. The patients were divided into group A, which included patients without SigBleed; group B, which included patients with SigBleed of a nonpelvic cause; and group C, which included patients with SigBleed caused by the SPF. The 3 groups were compared by univariate and multivariate analysis.

    Main Outcome Measure

    Significant bleeding from SPFs.


    Of 391 patients with SPFs, 280 (72%) were in group A, 90 (23%) were in group B, and 21 (5%) were in group C. Compared with group A patients, those in group C were older and had a lower hematocrit and systolic blood pressure on admission. They also had longer hospital stays and a higher mortality. The following independent predictors of SigBleed from SPF were identified: hematocrit of 30% or lower (odds ratio [OR], 43.93; 95% confidence interval [CI], 9.78-197.32; P < .001); presence of pelvic hematoma on computed tomographic scan (OR, 39.37; 95% CI, 4.58-338.41; P < .001); and systolic blood pressure of 90 mm Hg or lower (OR, 18.352; 95% CI, 1.98-169.87; P = .01). When all independent predictors were present, 100% of the patients had SigBleed; when all were absent, no one had SigBleed.


    The incidence of SigBleed due to SPFs is low (5% in this study) and independently predicted by an admission hematocrit of 30% or lower, the presence of a pelvic hematoma on computed tomographic scan, and systolic blood pressure of 90 mm Hg or lower.

  • A Clinical Tool for the Prediction of Venous Thromboembolism in Pediatric Trauma Patients

    Abstract Full Text
    JAMA Surg. 2016; 151(1):50-57. doi: 10.1001/jamasurg.2015.2670

    This review of 536 423 pediatric patients 0 to 17 years old using the National Trauma Data Bank from 2007 to 2012 develops a risk prediction calculator for venous thromboembolism in children admitted to the hospital after traumatic injury.

  • Prevalence of Domestic Violence Among Trauma Patients

    Abstract Full Text
    JAMA Surg. 2015; 150(12):1177-1183. doi: 10.1001/jamasurg.2015.2386

    This analysis assesses the reported prevalence of domestic violence among trauma patients.

  • Improving Hospital Quality and Costs in Nonoperative Traumatic Brain Injury: The Role of Acute Care Surgeons

    Abstract Full Text
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    JAMA Surg. 2015; 150(9):866-872. doi: 10.1001/jamasurg.2015.1134

    This cohort analysis compares the outcomes in patients with traumatic brain injury before and after implementation of the Brain Injury Guidelines protocol.

  • NEXUS Chest: Validation of a Decision Instrument for Selective Chest Imaging in Blunt Trauma

    Abstract Full Text
    free access
    JAMA Surg. 2013; 148(10):940-946. doi: 10.1001/jamasurg.2013.2757

    Rodriguez et al validate the derived decision instrument (NEXUS Chest) for identification of blunt trauma patients with very low risk of thoracic injury seen on chest imaging hypothesizing that NEXUS Chest would have high sensitivity (>98%) for the prediction of and clinical significance for thoracic injury seen on chest imaging.