Fat embolism syndrome after femur fracture fixation: a case report

Craig C Akoh; Cameron Schick; Jesse Otero; Matthew Karam

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$Fat embolism syndrome after femur fracture fixation: a case report$

Journal article

Open access

Peer reviewed

Fat embolism syndrome after femur fracture fixation: a case report

Craig C Akoh, Cameron Schick, Jesse Otero and Matthew Karam

The Iowa orthopaedic journal, Vol.34, pp.55-62

2014

PMCID: PMC4127739

PMID: 25328460

Appears in Diamond Open Access

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https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4127739/View

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Abstract

Fat embolism syndrome (FES) is a multi-organ disorder with potentially serious sequelae that is commonly seen in the orthopaedic patient population after femur fractures. The major clinical features of FES include hypoxia, pulmonary dysfunction, mental status changes, petechiae, tachycardia, fever, thrombocytopenia, and anemia. Due to technological advances in supportive care and intramedullary reaming techniques, the incidence of FES has been reported as low as 0.5 percent. Here, we present a rare case of FES with cerebral manifestations. A previously healthy 24-year old nonsmoking male was admitted to our hospital after an unrestrained head-on motor vehicle collision. The patient's injuries included a left olecranon fracture and closed bilateral comminuted midshaft femur fractures. The patient went on to develop cerebral fat embolism syndrome (CFES) twelve hours after immediate bilateral intramedullary nail fixation. His symptoms included unresponsiveness, disconjugate gaze, seizures, respiratory distress, fever, anemia, thrombocytopenia, and visual changes. Head computed tomography and brain magnetic resonance imaging showed pathognomonic white-matter punctate lesions and watershed involvement. With early recognition and supportive therapy and seizure therapy, the patient went on to have complete resolution of symptoms without cognitive sequelae.

Magnetic Resonance Imaging

Fracture Fixation - adverse effects

Thrombocytopenia - etiology

Humans

Embolism, Fat - etiology

Male

Thrombocytopenia - pathology

Syndrome

Young Adult

Seizures - pathology

Femoral Fractures - surgery

Fever - etiology

Seizures - etiology

Brain - pathology

Embolism, Fat - pathology

Fever - pathology

Details

Title: Subtitle: Fat embolism syndrome after femur fracture fixation: a case report
Creators: Craig C Akoh - University of Iowa Hospitals and Clinics Department of Orthopaedics and Rehabilitation
Cameron Schick - University of Iowa Hospitals and Clinics Department of Orthopaedics and Rehabilitation
Jesse Otero - University of Iowa Hospitals and Clinics Department of Orthopaedics and Rehabilitation
Matthew Karam - University of Iowa Hospitals and Clinics Department of Orthopaedics and Rehabilitation
Resource Type: Journal article
Publication Details: The Iowa orthopaedic journal, Vol.34, pp.55-62
Publisher: Dept. of Orthopaedics, The University of Iowa; United States
PMID: 25328460
PMCID: PMC4127739
ISSN: 1541-5457
eISSN: 1555-1377
Language: English
Date published: 2014
Academic Unit: Orthopedics and Rehabilitation
Record Identifier: 9984040464602771

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