Fat Embolism in Patients with an Isolated Fracture of the Femoral Shaft

Analysis of basic pathophysiologic variables in fat embolism patients is often restricted by the complexity of the different injuries present in each individual patient. To avoid this problem we investigated the presence of the fat embolism syndrome in patients with an ʼisolatedʼ fracture of the femoral shaft. Two groups were distinguishedthose who had an open fracture or a closed fracture treated operatively within 24 hours after the accident (decompression group), and those who were treated initially conservatively (nondecompressed group). Clinical fat embolism occurred only in patients in the nondecompressed group (3.5%). They showed significantly higher initial temperatures, lower pulse rates, a progressive hemoglobin decrease, and a fracture localization more proximal (p