Top

European Journal of Orthopaedic Surgery & Traumatology

Published in:

01-11-2013 | Up-to date Review and Case Report

Fatal fat embolism syndrome in a case of isolated L1 vertebral fracture-dislocation

Authors: Koun Yamauchi, Kazunari Fushimi, Tsuneko Ikeda, Masashi Fukuta

Published in: European Journal of Orthopaedic Surgery & Traumatology | Special Issue 2/2013

Abstract

Although fat embolism syndrome is a well-known complication of fractures of the long bones or pelvis, fat embolism syndrome occurring subsequent to fracture of the lumbar spine is rare. We report a fatal case of fat embolism syndrome characterized by fat and bone marrow embolism that occurred 36 h after an isolated fracture-dislocation of the L1 vertebra. A postmortem examination was performed and pathological finding demonstrated fat and bone marrow tissue which were disseminated in the bilateral pulmonary arteries. We need to be aware of the possibility of fat embolism syndrome as a complication of spinal fractures, including isolated vertebral body fractures.

Monto RR, Garcia J, Callaghan JJ (1990) Fatal fat embolism following total condylar knee arthroplasty. J Arthroplasty 12:291–299CrossRef

Spengler DM, Costenbader M, Bailey R (1976) Fat embolism syndrome following total hip arthroplasty. Clin Orthop Relat Res 11–12:105–107

Aoki N, Soma K, Shindo M, Kurosawa T, Ohwada T (1998) Evaluation of potential fat emboli during placement of intramedullary nails after orthopedic fractures. Chest 1:178–181CrossRef

Herndon JH, Bechtol CO, Crickenberger DP (1974) Fat embolism during total hip replacement. A prospective study. J Bone Joint Surg Am 10:1350–1362

Lewis D, Jones R, Carpenter C, James S (2007) Fatal fat embolism following an isolated vertebral fracture. Acta Orthop Belg 73(1):137–139PubMed

Lastra RR, Saldanha V, Balasubramanian M, Handal J (2010) Fatal fat embolism in isolated vertebral compression fracture. Eur Spine J 19(2):S200–S202PubMedCrossRef

Takahashi S, Kitagawa H, Ishii T (2003) Intraoperative pulmonary embolism during spinal instrumentation surgery. A prospective study using transoesopahgeal echocardiography. J Bone Joint Surg Br 85(1):90–94PubMedCrossRef

Brandt SE, Zeegers WS, Ceelen TL (1998) Fatal pulmonary fat embolism after dorsal spinal fusion. Eur Spine J 7(5):426–428PubMedCrossRef

Gittman JE, Buchanan TA, Fisher BJ, Bergeson PS, Palmer PE (1983) Fatal fat embolism after spinal fusion for scoliosis. JAMA 249(6):779–781PubMedCrossRef

10.

Temple JD, Ludwig SC, Ross WK, Marshall WK, Larsen L, Gelb DE (2002) Catastrophic fat embolism following augmentation of pedicle screws with bone cement:a case report. J Bone Joint Surg Am 84-A(4):639–642PubMed

11.

Akahashi Y, Narusawa K, Shimizu K, Takata M, Nakamura T (2006) Fatal pulmonary fat embolism after posterior spinal fusion surgery. J Orthop Sci 11(2):217–220CrossRef

12.

Monticelli F, Meyer HJ, Tutsch-Bauer E (2005) Fatal pulmonary cement embolism following percutaneous vertebroplasty (PVP). Forensic Sci Int 149(1):35–38PubMedCrossRef

13.

Aebli N, Krebs J, Davis G, Walton M, Williams MJ, Theis JC (2002) Fat embolism and acute hypotension during vertebroplasty: an experimental study in sheep. Spine (Phila Pa 1976) 27(5):460–466CrossRef

14.

Syed MI, Jan S, Patel NA, Shaikh A, Marsh RA, Stewart RV (2006) Fatal fat embolism after vertebroplasty: identification of the high-risk patient. Am J Neuroradiol 2:343–345

15.

Glover P, Worthley LI (1999) Fat embolism. Crit Care Resusc 1(3):276–284PubMed

16.

Gossling HR, Pellegrini VD Jr (1982) Fat embolism syndrome: a review of the pathophysiology and physiological basis of treatment. Clin Orthop Relat Res 3:68–82

17.

Pell AC, Christie J, Keating JF, Sutherland GR (1993) The detection of fat embolism by transoesophageal echocardiography during reamed intramedullary nailing. A study of 24 patients with femoral and tibial fractures. J Bone Joint Surg Br 12:921–925

18.

Hulman G (1988) Fat macroglobule formation from chylomicrons and non-traumatic fat embolism. Clin Chim Acta 177(2):173–178PubMedCrossRef

19.

Derks CM, Jacobovitz-Derks D (1977) Embolic pneumopathy induced by oleic acid. A systematic morphologic study. Am J Pathol 87(1):143–158PubMed

20.

Kao SJ, Yeh DY, Chen HI (2007) Clinical and pathological features of fat embolism with acute respiratory distress syndrome. Clin Sci Lond 113(6):279–285PubMedCrossRef

Title: Fatal fat embolism syndrome in a case of isolated L1 vertebral fracture-dislocation
Authors: Koun Yamauchi
Kazunari Fushimi
Tsuneko Ikeda
Masashi Fukuta
Publication date: 01-11-2013
Publisher: Springer Paris
Published in: European Journal of Orthopaedic Surgery & Traumatology / Issue Special Issue 2/2013
Print ISSN: 1633-8065
Electronic ISSN: 1432-1068
DOI: https://doi.org/10.1007/s00590-013-1171-8

At a glance: The STEP trials

Springer Medicine

Fatal fat embolism syndrome in a case of isolated L1 vertebral fracture-dislocation

Abstract

At a glance: The STEP trials

Springer Medicine

Abstract

Please log in to get access to this content

Other articles of this Special Issue 2/2013

Extraskeletal osteosarcoma with synchronous regional lymph node and soft tissue metastasis: a rare presentation of an uncommon tumour

Windsurfing hazard caused by needlefish

Intraoperative radiofrequency ablation for metastatic spine disease: report of 4 cases and review

A rare complication after intertrochanteric fracture treated with proximal femoral nail: femoral neck insufficiency fracture

A case of acute dorsal radiocarpal dislocation with radial styloid fracture

Cervical spondylodiscitis associated with oesophageal perforation: a rare complication after anterior cervical fusion