Fat Embolism Syndrome in Long Bone Fracture—Clinical Experience in a Tertiary Referral Center in Taiwan

Abstract

This 12-year interval retrospective study revealed modern epidemiologic results for FES in long bone fracture. Compared with the available literature in the recent decade, the incidence of FES in long bone fracture in our institution is less and the mortality rate is similar.

Cerebral fat embolism syndrome after long bone fracture due to gunshot injury

“…[6] The most common clinical symptoms were reported as hypoxemia (PaO2 < 70 mmHg), change of consciousness, infiltrates infiltration findings on chest plain film, and sudden drop in hemoglobin and platelets. [2] The present patient also had hypoxemia requiring mechanical ventilation, disturbance of conscioussness and a sudden drop in platelet count.…”

“…However, multiple microembolic infarcts could be seen in diffusion-weighted MRI. [23] Gregorakos et al .,[7] described two teenage males suffering from prolonged coma secondary to FES due to lower extremity fractures from a motor vehicle collision. MRI showed multiple areas of increased signal intensity in the cerebral white matter in the first patient and diffuse high signal intensity in periventricular and subcortical white matter in the second one.…”

“…The majority of case reports on FES found that cerebral dysfunction associated with FES to be reversible. [234] Parizel et al .,[8] described a teenage female who fractured her left tibia secondary to motor vehicle injury. Diffusion weighted MRI showed punctate foci of high signal intensity in subcortical white and gray matter and the patient had full neurological recovery by 1 week and repeated magnetic resonance images 4 weeks after the accident revealed disappearance of signal abnormalities.…”

“…Diffusion weighted MRI showed punctate foci of high signal intensity in subcortical white and gray matter and the patient had full neurological recovery by 1 week and repeated magnetic resonance images 4 weeks after the accident revealed disappearance of signal abnormalities. [2] The outcome of patients with FES who receive supportive care is generally complete resolution of pulmonary, neurological, and dermatological lesions with a mortality of less than 10%.…”

“…[12] Hypoxia or respiratory distress, deteriorating mental status, and petechial hemorrhage are the main diagnostic criteria; secondary diagnostic signs include tachycardia, fever, anemia, and thrombocytopenia typically seen in the context of long-bone fracture. [23] Neurologic symptoms can be transient and widely varies from a diffuse encephalopathy to focal deficits. [3] Fat emboli can pass through the pulmonary vasculature, resulting in systemic embolization, most commonly in the brain and kidneys.…”