Abstract
BackgroundFat embolism syndrome is a potentially fatal complication of long bone fractures. It is usually seen in the context of polytrauma or a femoral fracture. There are few reports of fat embolism syndrome occurring after isolated long bone fractures other than those of the femur.Case presentationWe describe a case of fat embolism syndrome in a 33-year-old Caucasian man. He was being seen for an isolated Gustilo’s grade II open tibial fracture. He was deemed clinically stable, so we proceeded to treat the fracture with intramedullary reamed nailing. He developed fat embolism syndrome intraoperatively and was treated successfully.ConclusionThis case caused us to question the use of injury severity scoring for isolated long bone fractures. It suggests that parameters that have been described in the literature other than that the patient is apparently clinically stable should be used to establish the best time for nailing a long bone fracture, thereby improving patient safety.
Highlights
Fat embolism syndrome is a potentially fatal complication of long bone fractures
This case caused us to question the use of injury severity scoring for isolated long bone fractures
It suggests that parameters that have been described in the literature other than that the patient is apparently clinically stable should be used to establish the best time for nailing a long bone fracture, thereby improving patient safety
Summary
Fat embolism syndrome is a potentially fatal complication of long bone fractures. It is usually seen in the context of polytrauma or a femoral fracture. There are few reports of fat embolism syndrome occurring after isolated long bone fractures other than those of the femur. Case presentation: We describe a case of fat embolism syndrome in a 33-year-old Caucasian man He was being seen for an isolated Gustilo’s grade II open tibial fracture. He was deemed clinically stable, so we proceeded to treat the fracture with intramedullary reamed nailing He developed fat embolism syndrome intraoperatively and was treated successfully. Fat embolism syndrome (FES) is a potentially fatal complication (mortality 10-36) [1,2] of long bone fractures. Most of the reported cases occurred in patients with multiple traumatic injuries that resulted in the systemic inflammatory response syndrome, which causes multi-organ damage via a reaction to free fatty acids [2].
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