title: Fat embolism: special situations bilateral femoral fractures and pathologic femoral fractures.
abstract: Few data are available in the literature regarding fat embolism in cases of bilateral femoral and pathological femoral fractures. The incidence of bilateral femoral fractures ranges from 2-9.5% of the total number of patients with femoral fractures, and they usually occur in high energy trauma and multi-trauma patients. Although injury severity scores tend to underestimate the severity of these injuries, fat embolism seems to occur in increased frequency ranging from 4.8-7.5%. Intramedullary nailing, which is the preferred surgical treatment, triggers a systemic inflammatory response that poses an additional burden to pulmonary function. In addition, the femur is a common site of metastatic bone disease. The treatment of impending and actual pathological fractures is complicated by increased rates of lung damage due to various factors. Fat embolism during treatment--mainly with intramedullary nails--generally seems to range from 0-10%.
authors.affiliation: University Hospital of Heraklion, Crete, Greece. kontak@med.uoc.gr
authors.forename: George M
authors.initials: GM
authors.lastname: Kontakis
authors.forename: Theodoros
authors.initials: T
authors.lastname: Tossounidis
authors.forename: Kurt
authors.initials: K
authors.lastname: Weiss
authors.forename: Hans-Christoph
authors.initials: HC
authors.lastname: Pape
authors.forename: Peter V
authors.initials: PV
authors.lastname: Giannoudis
mesh_terms: D004620:Embolism, Fat / Q000453:epidemiology / Q000209:etiology* / Q000473:pathology; D005264:Femoral Fractures / Q000150:complications* / Q000473:pathology; D006801:Humans; D015994:Incidence; D009104:Multiple Trauma; D012307:Risk Factors