Logo of The Journal of Bone & Joint Surgery (Br)
Quick search:        
          Advanced Search
Guest Access | Sign In
This Article
Right arrow Full Text (PDF)
Right arrow Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when eLetters are posted
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow My Folders
Right arrow Download to citation manager
Citing Articles
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Lécutier, M. A.
Right arrow Articles by Smith, A. H.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Lécutier, M. A.
Right arrow Articles by Smith, A. H.

AIR EMBOLISM AS A COMPLICATION OF MEDULLARY NAILING

M. A. Lécutier 1; and A. H. Smith 1

1 The departments of Pathology and Orthopaedics, Royal Hospital, Chesterfield

A case of fatal air embolism after Küntscher nailing of a fractured femur is described. Necropsy indicated that the only possible means of air entry was through the bone marrow. Subsequent discussion between the surgeon and the pathologist indicated that air must have been forced into the venous circulation through the marrow by repeated removal and reinsertion of nails, which allowed air to fill the punched-out marrow space when the nail was removed, the same air being forced into the marrow sinusoids when the nail was reinserted and hammered into position. This danger may be overcome 1) by allowing the site of operation to flood with blood by placing the patient in a "head up" position; 2) by flooding the operation site with saline; or 3) by assessing the calibre of nail required by radiological means rather than by trial and error.
(c) British Editorial Society of Bone and Joint Surgery All Rights Reserved
Registered charity no: 209299     Print ISSN: 0301-620X
Hip, Knee, Trauma, Upper limb, Foot & Ankle, Paediatrics, Oncology, Spine, Arthroplasty, General