Fat embolism following a cemented hemiarthroplasty

  • E. J. Karadimas
  • J. B. Kapotas
  • E. G. Pachantouris
  • J. E. Karadimas
Case Report
  • 77 Downloads

Abstract

Purpose

Fat-embolism (FE) is a rare but severe complication involving the long tubular bones, presented during the second posttraumatic or post-operative day. The main characteristics are pulmonary distress, mental status disturbances and petechiae. The purpose is to present our case of fat embolism and the final outcome.

Materials and methods

A female patient, aged 72, was admitted in our hospital after a low energy fall. The examination revealed a Garden IV subcapital hip fracture. A cemented hemiarthroplasty was performed in less than 24 h after the appropriate preoperative control.

Results

The operation finished uncomplicated, but later the same day, the patient became hyper-febrile with signs of confusion. During the first post-operative day she deteriorated further and a full investigation was performed. The improvement started the following day and petechiae were developed. She was able to follow the post-operative mobilization protocol and was discharged on the 12th post-operative day.

Discussion

We present a full documented case of FE with all the triad characteristics, which recovered rapidly and fully. We consider FE a severe complication and due to the mortality rate, all the orthopaedic surgeons must be aware of the early signs.

Keywords

Hip arthroplasty Arthroplasty complications Fat embolism Cemented hemi arthroplasty 

Embolie graisseuse après prothèse intermédiaire de hanche

Résumé

Buts

L’embolie graisseuse est une complication rare mais sévère des os longs, qui s’installe au 2ème jour post-traumatique ou post-opératoire. Les caractéristiques les plus habituelles sont la détresse respiratoire, les troubles psychiques et les pétéchies. Notre but est de présenter un cas d’embolie graisseuse et le résultat final.

Matériel et Méthode

Une patiente âgée de 72 ans fut admise dans notre hôpital après une chute à basse énergie. Un diagnostic de fracture sous-capitale Garden IV fut posé. Une hémi-arthroplastie cimentée fut réalisé en moins de 24 heures après le bilan pré-opératoire approprié.

Results

L’opération se déroula sans complications, mais le même jour, après l’opération, la patiente devint hyperthermique et présenta des signes de confusion. Au premier jour postopératoire, la détérioration de l’état général augmenta et un examen approfondi fut décidé. Une amélioration s’installa à J 2 avec apparition de pétéchies. La patiente put alors réintégrer le protocole de mobilisation postopératoire et elle quitta l’hôpital à J 12.

Discussion

Nous présentons un cas totalement documenté d’embolie graisseuse avec la triade caractéristique et qui a récupéré rapidement et complètement. Nous considérons l’embolie graisseuse comme une complication grave et, en tenant compte de sa mortalité, nous estimons que tout chirurgien orthopédiste doit être attentif à l’apparition de ses symptômes précoces.

Mots clés

Arthroplastie de hanche Complications des arthroplasties Embolie graisseuse Hémi-arthroplastie cimentée 

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Copyright information

© Springer-Verlag 2007

Authors and Affiliations

  • E. J. Karadimas
    • 1
    • 2
  • J. B. Kapotas
    • 1
  • E. G. Pachantouris
    • 1
  • J. E. Karadimas
    • 1
  1. 1.B’ Orthopaedic Department“Hygeia” HospitalMaroussi, AthensGreece
  2. 2.AthensGreece

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