scholarly journals Fat Embolism Syndrome: A Case Report and Review Literature

2018 ◽  
Vol 2018 ◽  
pp. 1-6 ◽  
Author(s):  
Nattaphol Uransilp ◽  
Sombat Muengtaweepongsa ◽  
Nuttawut Chanalithichai ◽  
Nattapol Tammachote
Keyword(s):  
Bone Fractures ◽  
Specific Treatment ◽  
Fat Embolism ◽  
Review Literature ◽  
Long Bone ◽  
Laboratory Findings ◽  
Fat Embolism Syndrome ◽  
Embolism Syndrome ◽  
Neck Fracture ◽  
Magnetic Resonance Imaging Mri

Fat embolism syndrome (FES) is a life-threatening complication in patients with orthopedic trauma, especially long bone fractures. The diagnosis of fat embolism is made by clinical features alone with no specific laboratory findings. FES has no specific treatment and requires supportive care, although it can be prevented by early fixation of bone fractures. Here, we report a case of FES in a patient with right femoral neck fracture, which was diagnosed initially by Gurd’s criteria and subsequently confirmed by typical appearances on magnetic resonance imaging (MRI) of the brain. The patient received supportive management and a short course of intravenous methylprednisolone.

Timing of definitive fixation of major long bone fractures: Can fat embolism syndrome be prevented?

Injury ◽  
2017 ◽  
Vol 48 ◽  
pp. S3-S6 ◽  
Author(s):  
Taco J. Blokhuis ◽  
Hans-Christoph Pape ◽  
Jan-Paul Frölke
Keyword(s):  
Bone Fractures ◽  
Fat Embolism ◽  
Long Bone ◽  
Fat Embolism Syndrome ◽  
Long Bone Fractures ◽  
Embolism Syndrome

scholarly journals Cerebral fat embolism syndrome (FES): similar cases with different outcomes

2018 ◽  
pp. bcr-2018-225261
Author(s):  
Alexis Jorgensen ◽  
Azhar Bashir ◽  
Jibanananda Satpathy
Keyword(s):  
Bone Fractures ◽  
Plate Osteosynthesis ◽  
Neurological Impairment ◽  
Fat Embolism ◽  
Sudden Onset ◽  
Clinical Syndrome ◽  
Long Bone ◽  
Fat Embolism Syndrome ◽  
Long Bone Fractures ◽  
Embolism Syndrome

Fat embolism syndrome (FES) is a rare multisystem, clinical syndrome occurring in 0.9%–2.2% of long-bone fractures. The severity of FES can vary from subclinical with mild respiratory changes and haematological aberrations to a fulminant state characterised by sudden onset of severe respiratory and neurological impairment. Here we present two patients with cerebral FES secondary to femur fracture. Both patients exhibited profound neurological impairment with varied outcomes. Our cases highlight the importance of a high clinical suspicion of FES in patients with long-bone fractures and neurological deterioration. We recommend early plate osteosynthesis to prevent additional emboli in patients with FES and situational placement of intracranial pressure monitoring. Finally, cerebral FES has low mortality even in a patient with tentorial herniation and fixed, dilated pupils.

scholarly journals Management of long bone fractures in patients with cerebral fat embolism syndrome

2020 ◽  
Vol 30 ◽  
pp. 100365
Author(s):  
Rebecca D. Chase ◽  
Sheena J. Amin ◽  
Rakesh P. Mashru ◽  
Henry J. Dolch ◽  
Kenneth W. Graf
Keyword(s):  
Bone Fractures ◽  
Fat Embolism ◽  
Long Bone ◽  
Fat Embolism Syndrome ◽  
Long Bone Fractures ◽  
Embolism Syndrome ◽  
Cerebral Fat Embolism Syndrome

scholarly journals Post‐traumatic cerebral fat embolism syndrome with a favourable outcome: a case report

BMC Neurology ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Wei Wang ◽  
Weibi Chen ◽  
Yan Zhang ◽  
Yingying Su ◽  
Yuping Wang
Keyword(s):  
Bone Fractures ◽  
Fat Embolism ◽  
Long Bone ◽  
Cerebellar Hemisphere ◽  
Field Pattern ◽  
Acute Chest Syndrome ◽  
Multiple Fractures ◽  
Cognitive Changes ◽  
Fat Embolism Syndrome ◽  
Embolism Syndrome

Abstract Background Fat embolism syndrome (FES) is a change in physiology resulting from mechanical causes, trauma, or sepsis. Neurological manifestations of FES can vary from mild cognitive changes to coma and even cerebral oedema and brain death. Here, we present an unusual case of cerebral fat emboli that occurred in the absence of acute chest syndrome or right-to-left shunt. Case presentation A previously healthy 57-year-old right-handed male was admitted to our department because of unconsciousness after a car accident for 3 days. He suffered from multiple fractures of the bilateral lower extremities and pelvis. This patient had severe anaemia and thrombocytopenia. Head MRI showed multiple small lesions in the whole brain consistent with a “star field” pattern, including high signals on T2-weighted (T2w) and fluid-attenuated inversion recovery (FLAIR) images in the bilateral centrum semiovale; both frontal, parietal and occipital lobes; and brainstem, cerebellar hemisphere, and deep and subcortical white matter. Intravenous methylprednisolone, heparin, mannitol, antibiotics and nutritional support were used. Although this patient had severe symptoms at first, the outcome was favourable. Conclusions When patients have long bone and pelvic fractures, multiple bone fractures and deteriorated neurological status, cerebral fat embolism (CFE) should be considered. Additionally, CFE may occur without an intracardiac shunt. The early diagnosis and appropriate management of FES are important, and prior to and following surgery, patients should be monitored comprehensively in the intensive care unit. With appropriate treatment, CFE patients may achieve good results.

scholarly journals Fat Embolism Syndrome Mimicking a COVID-19 Infection

2021 ◽  
Vol 2021 ◽  
pp. 1-4
Author(s):  
Alexandru Leonard Alexa ◽  
Adela Hilda Onutu
Keyword(s):  
Intensive Care ◽  
Mental Status ◽  
Bone Fractures ◽  
Altered Mental Status ◽  
Fat Embolism ◽  
Multiple Organ ◽  
Long Bone ◽  
Fat Embolism Syndrome ◽  
Orthopedic Procedure ◽  
Embolism Syndrome

Fat embolism syndrome (FES) is a multiple organ disorder that can appear after pelvic and long bone fractures. The most common clinical finding is hypoxia, accompanied by diffuse petechiae, alveolar infiltrates, altered mental status, fever, polypnea, and tachycardia. We present a mild FES case on a 32-year-old man with no medical history admitted for an orthopedic procedure, following both tibia and fibulae fractures. Thirty hours postoperatively, he developed respiratory failure with altered mental status and needed admission in the intensive care unit. The chest radiography and later chest tomography raised the suspicion of a COVID-19 disease, even if our first suspicion was FES. After being carefully investigated in a dedicated COVID-19 ward and three negative RT-PCR SARS-CoV-2 tests, he returned to continue supportive treatment in the orthopedic intensive care ward. His evolution was favorable with discharge at ten days, without sequelae. In the context of the SARS CoV-2 pandemic, differential diagnosis has become an increasingly challenging process. Added to the variety of preexisting respiratory diseases and disorders, the COVID-19 infection, with its symptomatology so similar to multiple other pulmonary diseases, must not cloud our clinical judgement.

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