Nigerian Journal of Orthopaedics and Trauma

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Fatal Fat Embolism In Traumatized Patients: An Experience From Eastern Nigeria

RO Ofiaeli


OBJECTIVE: The aim was to highlight the problems of fat embolism in our environment.

METHOD: All the patients who had fat embolism in the author's practice from 1988 – 2001 at our Lady of Lourdes Hospital, Ihiala and Holy Cross Hospital, Nnewi, were reviewed. Information on age, sex, occupation, cause of injury, injury severity score, operative intervention (if any), symptoms of embolism, changes in clinical status and time of death were extracted.

RESULTS: Six male patients with a mean age of 37.8+ 15.4 years developed fat embolism during the study period. One had bilateral fracture of the femur while the rest had fracture of the femur in association with other minor injuries. One patient developed drowsiness, respiratory distress and lapsed into coma 12 hours after injury. He died 24 hours later despite prompt treatment with anticoagulants and assisted respiration with a ventilator. Another patient with crush injury of the thigh developed similar symptoms and died within 12 hours of sustaining injury. The remaining 4 patients had intramedullary nailing of the femur, became drowsy, had respiratory distress and eventually lapsed into coma and died at variable length of time after surgery (Range 12 hours to 10 days). All the diagnoses were made on clinical observations.

CONCLUSION: Fat embolism is an important cause of mortality in road traffic accident victims. Prevention can be achieved by administering adrenergic blocking agents like propranalol and guanethidine, administration of Methylprednisolone (1.5mg/kg body weight) intravenously every 6 hours in the immediate post injury period.

Nig Jnl Orthopaedics & Trauma Vol.2(1) 2003: 22-25
AJOL African Journals Online