title: Fat embolism and related effects during reamed and unreamed intramedullary nailing in a pig model.
abstract: OBJECTIVE
  To determine whether reamed or unreamed femoral intramedullary nailing is more adverse to pulmonary function, the authors compared three populations of healthy pigs, analyzing the biochemical and hemodynamic effects related to fat embolism. Likewise, the authors histologically evaluated the presence of bone marrow fat embolism in lungs, heart, kidney, brain, and retina.
  
  
  METHODS
  Randomized, experimental model.
  
  
  METHODS
  Laboratory.
  
  
  METHODS
  Twenty-five male Duroc Jersey adult healthy pigs divided in three groups.
  
  
  METHODS
  Reamed and unreamed intramedullary nailing.
  
  
  METHODS
  Biochemical, hemodinamical, and histologic analysis.
  
  
  METHODS
  In the first group of ten pigs, a reamed nail was inserted; in the second group of ten specimens, the authors placed an unreamed nail; and in the third group of five animals (control), only the surgical approach was made without opening the medullary cavity.
  
  
  RESULTS
  The authors did not find statistically significant differences in pulmonary function between the reamed and unreamed group in the hemodynamic, biochemical, and histopathologic parameters evaluated. The histologic analysis of the lung tissue revealed a statistically significant difference between the nailed groups and the control (P < 0.04).
  
  
  CONCLUSIONS
  In this animal model, the results indicate that pulmonary changes and fat embolization during intramedullary nailing occur to the same degree in reamed and in unreamed femurs.
authors.affiliation: "Carlos E. Ottolenghi" Orthopaedic Department, Hospital Italiano de Buenos Aires, Argentina. buttarojr@yahoo.com
authors.forename: M
authors.initials: M
authors.lastname: Buttaro
authors.forename: E
authors.initials: E
authors.lastname: Mocetti
authors.forename: V
authors.initials: V
authors.lastname: Alfie
authors.forename: G
authors.initials: G
authors.lastname: Paniego
authors.forename: L
authors.initials: L
authors.lastname: Piñeiro
mesh_terms: D000818:Animals; D001856:Bone Marrow Examination; D001921:Brain / Q000378:metabolism / Q000473:pathology / Q000503:physiopathology; D004195:Disease Models, Animal; D004620:Embolism, Fat / Q000209:etiology / Q000378:metabolism* / Q000503:physiopathology*; D005269:Femur / Q000378:metabolism* / Q000503:physiopathology* / Q000601:surgery; D005594:Fracture Fixation, Intramedullary / Q000009:adverse effects*; D006321:Heart / Q000503:physiopathology; D006439:Hemodynamics / Q000502:physiology; D007668:Kidney / Q000378:metabolism / Q000473:pathology / Q000503:physiopathology; D008168:Lung / Q000378:metabolism / Q000473:pathology / Q000503:physiopathology; D008297:Male; D009206:Myocardium / Q000378:metabolism / Q000473:pathology; D011897:Random Allocation; D012129:Respiratory Function Tests; D012160:Retina / Q000378:metabolism / Q000473:pathology / Q000503:physiopathology; D013552:Swine