Fat Embolism Syndrome (Subscribe)  

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Our objective was to determine the effect of corticosteroids in preventing FES in patients with long-bone fractures.
Conclusion: Evidence suggests that corticosteroids may be beneficial in preventing FES and hypoxia but not mortality in patients with long-bone fractures. The risk of infection is not increased with the use of cortisosteroids. However, methodological limitations of...

Mr Gurd Shergill and Mr Harish Parmar Archive copy from fractures.com
Fat embolism and the associated fat embolism syndrome is a serious and potentially life threatening complication of long bone trauma, blunt trauma and intramedullary manipulation. However, some seemingly unrelated conditions have also resulting in fat embolism, such as diabetes, burns, severe...

Fat embolism syndrome follows long bone fractures. Its classic presentation consists of an asymptomatic interval followed by pulmonary and neurologic manifestations combined with petechial hemorrhages. The syndrome follows a biphasic clinical course. The initial symptoms are probably caused by mechanical occlusion of multiple blood vessels with fat globules that are...

eMedicine Article (2004) by Lisa Kirkland MD (Internist)
Synonyms and related keywords: fat embolism syndrome, FES, fat emboli, fat embolus, fat droplet in venous system, blunt trauma, fracture complication, blunt trauma complication, altered mental status

In 1862, Zenker first described this syndrome at autopsy. In 1873, von Bergmann clinically diagnosed fat embolism syndrome for the first time.
Pathophysiology Two theories about the syndrome exist. First, the mechanical theory states that large fat droplets are released into the venous system. These droplets are deposited in the pulmonary capillary...

Synonyms: fat embolism syndrome and FES
Fat embolism can be difficult to diagnose. It most often follows a closed fracture of a long bone but there are many other causes.
The principal clinical features of fat embolism syndrome are:
* Respiratory failure
* Cerebral dysfunction
...

Fat embolism syndrome, a condition characterized by hypoxia, bilateral pulmonary infiltrates, and mental status change, is commonly thought of in association with long-bone trauma. Fat embolization can frequently take place, however, within the setting of elective and semiacute orthopedic procedures.[1] In particular, there is a high incidence of fat embolization...

Case reports and a review of Toronto experience. Drummond, Salter & Boone CMAJ 1969 (full text)

To undertake a current search for Fat Embolism Syndrome (FES) as a major subject in English language orthopaedic journals in Medline (PubMed) copy and paste the following search string or use the "Create Bibliography" link.
"embolism, fat"[majr] AND (jrid22024 OR jrid2275 OR jrid2208 OR jrid32471 OR jrid3046 OR jrid1981 OR jrid22800...

Wheeless' Textbook of Orthopaedics
FES results when embolic marrow fat macroglobules damage small vessel perfusion leading to endothelial damage in pulmonary capillary beds leading to respiratory failure and ARDS like picture;

Fat Embolism syndrome: A review giving most importance on its clinical manifestations, diagnosis and therapy.

Altaf Hussain: A Fatal Fat Embolism. The Internet Journal of Anesthesiology. 2004. Volume 8 Number 2.
Fat Embolism and the associated Fat Embolic Syndrome is a serious and potentially life threatening condition. It tends to occur most frequently after fractures or intramedullary instrumentation of long bones particularly the femur and tibia....

Conclusion Fat embolism syndrome may occur as a fulminant complication following femoral fracture repair in the presence of a concomitant atrial septal defect with right-to-left shunt. Thus, in patients with cardiac right-to-left shunts, femurs should not be nailed intramedullary, not even in cases of isolated injuries
Post-traumatic fulminant paradoxical fat embolism syndrome...

Full text: J Clin Pathol Suppl (R Coll Pathol). 1970; 4: 123–131. G Szabó