Case Report
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Sep 26, 2021; 9(27): 8260-8267
Published online Sep 26, 2021. doi: 10.12998/wjcc.v9.i27.8260
Early acute fat embolism syndrome caused by femoral fracture: A case report
Jia Yang, Zhong-Ning Cui, Jia-Nan Dong, Wen-Bo Lin, Jiang-Tao Jin, Xiao-Jie Tang, Xiao-Bo Guo, Shao-Bo Cui, Ming Sun, Chen-Chen Ji
Jia Yang, Zhong-Ning Cui, Jiang-Tao Jin, Xiao-Bo Guo, Department of Orthopaedic, Jincheng General Hospital, Jincheng 048006, Shanxi Province, China
Jia-Nan Dong, Department of Gynecology, Gaoping People’s Hospital, Jincheng 048400, Shanxi Province, China
Wen-Bo Lin, Department of Orthopaedic, Shanghai Changzheng Hospital, Shanghai 200001, China
Xiao-Jie Tang, Department of Spinal Surgery, The Yantai Affiliated Hospital of Binzhou Medical University, Yantai 264000, Shandong Province, China
Shao-Bo Cui, Chen-Chen Ji, Department of Critical Care Medicine, Jincheng General Hospital, Jincheng 048006, Shanxi Province, China
Ming Sun, Department of Emergency, Jincheng General Hospital, Jincheng 048006, Shanxi Province, China
Author contributions: Yang J and Cui ZN participated in the diagnosis and treatment of the patient, provided follow-up, drafted and reviewed the manuscript; Dong JN, Jin JT, Tang XJ, Guo XB, Cui SB, Sun M and Ji CC acquired clinical data; Yang J and Lin WB conducted investigations, reviewed literature, and assisted in polishing the manuscript for final publication; all of the authors read and approved the final manuscript.
Informed consent statement: Consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: All the authors declare no conflicts of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Zhong-Ning Cui, MM, Chief Doctor, Department of Orthopaedic, Jincheng General Hospital, Chang’an Road, Jincheng 048006, Shanxi Province, China. jmjtzyyczn@163.com
Received: May 20, 2021
Peer-review started: May 20, 2021
First decision: June 15, 2021
Revised: June 23, 2021
Accepted: August 5, 2021
Article in press: August 5, 2021
Published online: September 26, 2021
Abstract
BACKGROUND

Fat embolism syndrome (FES) is a rare complication caused by the presence of fat particles in the microcirculation, which usually occurs within 12-72 h after trauma. At present, there have been few cases of fat embolism presenting within 3 h after trauma. Here, we report a case of femoral fracture complicated with an acute fat embolism caused by a car accident.

CASE SUMMARY

A 29-year-old woman with pain, swelling and limited movement of her left lower limb after a car accident was taken by ambulance to our hospital. X-ray examination showed fracture of the middle and lower part of the left femur and fracture of the base of the left fifth metatarsal bone. She was hospitalized and admitted to the orthopedic ward. After the attending doctor performed tibial tubercle bone traction, the patient became confused, followed by respiratory distress. Finally, she was transferred to the intensive care unit. After nearly a month of treatment in the intensive care unit, the patient's cognitive function gradually recovered over 6 mo.

CONCLUSION

For patients with early traumatic fractures, young emergency physicians and orthopedics should be aware of the possibility of FES.

Keywords: Fat embolism syndrome, Femoral fracture, Respiratory distress, Diagnosis, Outcome, Case report

Core Tip: Early fat embolism syndrome (FES) is a rare complication of traumatic orthopedics. For patients with sudden hypoxemia and atypical neurological symptoms, young orthopedic surgeons on duty and emergency department physicians should take these symptoms seriously and be highly suspicious of FES. These patients should be immediately transferred to the intensive care unit for life-supportive treatment.