title: Fat embolism syndrome in long bone fracture--clinical experience in a tertiary referral center in Taiwan.
abstract: BACKGROUND
  Fat embolism syndrome (FES) is a potentially fatal complication of long bone fractures. There have been no reports of FES in long bone fractures in this decade in Taiwan. The purpose of this study was to review the FES experiences in a tertiary referral center between January 1997 and February 2008.
  
  
  METHODS
  Between January 1997 and February 2008, 13 patients with long bone fractures with documented FES in our institution were reviewed. FES was diagnosed clinically by at least 2 major criteria or 1 major with at least 4 minor signs of Gurd's criteria.
  
  
  RESULTS
  The incidences of FES, less than those reported in the literature, were 0.15% in fracture of the tibia, 0.78% in fracture of the femur and 2.4% in multiple fractures. The mortality rate of FES, similar to other available results, was about 7.7%. All cases were less than 35 years old, except for 1 70-year-old male. Fat embolism occurred within an average of 48.5 hours after long bone fracture. Eleven presented with sudden drop in hemoglobin level, dropping 4.2 g/dL on average. Nine presented with thrombocytopenia, and 10 presented with sudden drop in platelet count, dropping 140,000/dL on average. Two had cerebral sequelae without recovery at the last 48-month follow-up.
  
  
  CONCLUSIONS
  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.
authors: Department of Orthopedic Surgery, China Medical University Hospital, Taichung, Taiwan, R.O.C.
authors: I-Tzun
authors: IT
authors: Tsai
authors: Chin-Jung
authors: CJ
authors: Hsu
authors: Ying-Hao
authors: YH
authors: Chen
authors: Yi-Chin
authors: YC
authors: Fong
authors: Horng-Chaung
authors: HC
authors: Hsu
authors: Chun-Hao
authors: CH
authors: Tsai
mesh_terms: D000328:Adult; D000368:Aged; D004620:Embolism, Fat / Q000209:etiology* / Q000401:mortality; D005260:Female; D005264:Femoral Fractures / Q000150:complications; D050723:Fractures, Bone / Q000150:complications*; D006801:Humans; D008297:Male; D012189:Retrospective Studies; D013624:Taiwan; D013978:Tibial Fractures / Q000150:complications