Congratulations to Evan M. Renz, MD, of the US Army Institute of Surgical Research in Fort Sam Houston, Texas, and the Uniformed Services University of the Health Sciences in Bethesda, Maryland; Geoffrey Ling, MD, PhD, of the Uniformed Services University of the Health Sciences in Bethesda, Maryland; Kevin J. Mork, MD, of Altru Health System in Fargo, North Dakota; and James Ecklund, MD, of the Uniformed Services University of the Health Sciences in Bethesda, Maryland, and Virginia Commonwealth University, Richmond; they coauthored the winning Image of the Year for 2012. Their Image of the Month article on a foreign body in the skull appeared in the April 2012 issue (Arch Surg. 2012;147:391-392). This year was notable for the numerous correlations of interesting preoperative radiographic images with intraoperative or pathologic images. The winning images illustrate an interesting and, for American surgeons, rare mechanism of injury. Their appeal, however, goes beyond surgical interest. In recent decades, the media have given us many photographs from around the world of armed men firing their automatic weapons wildly into the sky in uninhibited group celebration of some event. When gravity finally overcomes the effect of muzzle velocity and these bullets return to earth, what is the risk to the crowd below? In addition to the interests of current events, this article provides a succinct summary of surgical management principles. We are rightly warned not to take a Kelly clamp in the emergency department and cavalierly extract a protruding foreign body that penetrates the skull. These are images of an unusual injury that also remind us that we live in a global village.
Please revisit our April 2012 issue to determine the most appropriate initial management.
Image of the Year for 2012.
Image of the Year for 2012. Arch Surg. 2012;147(12):1140. doi:10.1001/2013.jamasurg.202