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Reliable, easy-to-read patient information on common medical conditions — written in plain language, free of jargon, and grounded in current evidence. Browse the most frequent diagnoses, understand what they mean for everyday life, and learn which steps and questions help you have a focused conversation with your doctor.

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Fat embolism syndrome primary prevention

Introduction

Overview

Overview

Effective measurement for the primary prevention of fat embolism include early fixation of long bone fractures, external fixation with a plate and screw and use of small-diameter nails.

Primary Prevention

Primary Prevention

Effective measurement for the primary prevention of fat embolism are as follows:[1]

Pre-operative preventive measures:

  • Preoperative intravenous injection of dexamethasone.[2]
  • Continuous pulse oximetry to detect hypoxemia at early stages.[3][4][5]
  • Early fixation of long-bone fracture.
  • External fixation or fixation with plate and screw decreases the possibility of fat embolism than than nailing the medullary cavity and venting the medullary canal during nailing.[4]
  • If nails are needed, smaller-diameter nails and unreamed nailing may be better.[6]

In-operation preventive measures:

In patients having surgery for long bone fractures following preventive measures should be taken:

  • Early detection of the symptoms by careful vigilence and high degree of clinical suspicion.
  • Continuous monitoring for the fall in oxygen saturation.
  • An early initiation of supplemental oxygen and steroids may help in inhibiting the hypoxic insult and manifestations of full-blown FES.
  • The patient should not be over sedated.
  • Careful monitroing of vitals and temperature is mandatory.
  • Periodic neurological assessment.
  • Albumin should be used for volume resuscitation as it binds with free fatty acids and reduces lung injury.
References

References

  1. ↑ Jiang J, Wang H, Wang Y (2010). “[Clinical study on effect of dexamethasone in preventing fat embolism syndrome after cemented hip arthroplasty]”. Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 24 (8): 913–6. PMID 20839434.
  2. ↑ Cavallazzi R, Cavallazzi AC (2008). “[The effect of corticosteroids on the prevention of fat embolism syndrome after long bone fracture of the lower limbs: a systematic review and meta-analysis]”. J Bras Pneumol. 34 (1): 34–41. PMID 18278374.
  3. ↑ Wong MW, Tsui HF, Yung SH, Chan KM, Cheng JC (2004). “Continuous pulse oximeter monitoring for inapparent hypoxemia after long bone fractures”. J Trauma. 56 (2): 356–62. doi:10.1097/01.TA.0000064450.02273.9B. PMID 14960980.
  4. ↑ 4.0 4.1 Schmidt J, Sulk C, Weigand C, La Rosée K, Schneider T (2001). “[Preventing fat embolism syndrome (FES) in implantation of cemented hip endoprosthesis shafts with a trans-prosthetic drainage system (TDS)]”. Biomed Tech (Berl). 46 (11): 320–4. PMID 11778316.
  5. ↑ Schonfeld SA, Ploysongsang Y, DiLisio R, Crissman JD, Miller E, Hammerschmidt DE; et al. (1983). “Fat embolism prophylaxis with corticosteroids. A prospective study in high-risk patients”. Ann Intern Med. 99 (4): 438–43. PMID 6354030.
  6. ↑ Pitto RP, Kössler M, Draenert K (1998). “[Prevention of fat and bone marrow embolism in cemented total hip endoprosthesis with vacuum cement technique]”. Z Orthop Ihre Grenzgeb. 136 (4): Oa24. PMID 9795426.

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] ; Associate Editor(s)-in-Chief: Feham Tariq, MD [2]