Fat Embolism in Long Bone Fracture Patients and its Complications: A Prospective Study

Vol 6 | Issue 1 | Jan-Jun 2020 | page:2-5 – Dheeraj Attarde, Atul Patil, Chetan Pradhan, Chetan Puram, Adarsh Kota, Parag Sancheti, Ashok Shyam


Author: Dheeraj Attarde [1], Atul Patil [1], Chetan Pradhan [1], Chetan Puram [1], Adarsh Kota [1], Parag Sancheti [1], Ashok Shyam [1,2]

[1] Sancheti Institute of Orthopaedics and Rehabilitation, Pune, India.
[2] Indian Orthopaedic research group, Thane, India.

Address of Correspondence
Dr. Dheeraj Attarde,
Sancheti Institute of Orthopaedics and Rehabilitation, Pune, India.
E-mail: dheerajattarde@yahoo.in


Abstract

Background: Incidence of fat embolism after long bone fracture in Indian scenario is not studied much. In our study we try to analyse data over 2 years to find incidence and its complications.
Materials and Methods: Two hundred FES (fat embolism syndrome ) suspected patients secondary to long bone fractures admitted over a 1 year period included. Patients satisfying the clinical criteria proposed by Gurd and Wilson, and Schonfeld were included in the study. Clinical features, risk factors, complications and any sequelae were noted.
Results: Out of 200 patient’s majority were male patients. Maximum (85.5%) cases were used immobilizers to stabilize case. Isolated fractures (97%) were more compare to multiple fracture (3%). Associated features included features of altered sensoriam (n = 14, 7%), petechial rash (6%), tachycardia (16.5%) and fever (14.5%). Hypoxemia was demonstrable in 25.5% (51patients) cases. Fat embolism was found in 2% (4 cases) study population. Hypoxia @ 72 hours more in multiple fractures (50%) compare to isolated fractures (4.6%). This association was statistically significant. (P<0.05) No long-term sequelae were observed.
Conclusion: We conclude that in our representative population the incidence of fat embolism is slightly higher compared to other population. This amounts to 2% of people with long bone fractures of lower limb. Fat embolism was more in femur fractures compared to tibia fractures and the chance of fat embolism was more in multiple fractures when compared to isolated fractures. The incidence of fat embolism was more in closed fractures as compared to open fractures. Other salient features of the study were the increased incidence of fat embolism noted in fractures which were not immobilized.
Key Words: Accidents; ARDS; Fat embolism syndrome; Fracture.


References

1. Saigal R, Mittal M, Kansal A, Singh Y, Kolar P, Jain S. Fat embolism syndrome. JAPI. 2008 Apr;56.
2. Akhtar S. Fat embolism. Anesthesiology clinics. 2009 Sep 1;27(3):533-50.
3. Maitre S. Causes, clinical manifestations, and treatment of fat embolism. Virtual Mentor. 2006 Sep 1;8(9):590-2.
4. Stein PD, Yaekoub AY, Matta F, Kleerekoper M. Fat embolism syndrome. The American journal of the medical sciences. 2008 Dec 1;336(6):472-7.
5. Bulger EM, Smith DG, Maier RV, Jurkovich GJ. Fat embolism syndrome: a 10-year review. Archives of surgery. 1997 Apr 1;132(4):435-9.
6. Peltier L.F.: Fat embolism: A perspective. Clin Orthop 1988;232:263-270.
7. Allgower M., Durig M., Wolff G.: Infection and trauma. Surg Clin North Am 1980;60:133-144.
8. Beck J.P., Collins J.A.: Theoretical and clinical aspects of post-traumatic fat embolism syndrome. Instr Course Lect 1973;23:38-87..


How to Cite this article:  Attarde D, Patil A, Pradhan C, Puram C, Kota A, Sancheti P, Shyam A | Fat Embolism in Long Bone Fracture Patients and its Complications- A Prospective Study | Trauma International | January-June 2020; 6(1):2-5.

 


(Abstract)(Full Text HTML)   (Download PDF)