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Journal of Bone and Joint Surgery - British Volume, Vol 75-B, Issue 6, 921-925
Copyright © 1993 by British Editorial Society of Bone and Joint Surgery

Articles

The detection of fat embolism by transoesophageal echocardiography during reamed intramedullary nailing. A study of 24 patients with femoral and tibial fractures

AC Pell, J Christie, JF Keating, and GR Sutherland

Edinburgh Royal Infirmary, Scotland, UK.

We performed transoesophageal echocardiography on 24 patients during reamed intramedullary nailing of 17 tibial and seven femoral fractures. In 14 patients there was only minimal evidence of emboli passing through the heart, but in six copious showers of small emboli (< 10 mm maximum dimension) were observed. In four other patients, there were also multiple large emboli (> 10 mm maximum dimension). Three of these patients developed fat embolism syndrome postoperatively and one died. Earlier nailing was associated with smaller quantities of emboli.




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Hip, Knee, Trauma, Upper limb, Foot & Ankle, Paediatrics, Oncology, Spine, Arthroplasty, General