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Langenbecks Archiv für Chirurgie

, Volume 326, Issue 4, pp 367–379 | Cite as

Zur Bedeutung der Spongiosa- und Knochenmarks-Embolie in die Lunge

  • L. Zichner
Article

The importance of pulmonary embolism by bone fragments and bone marrow

Summary

  1. 1.

    The frequency of pulmonary embolism by bone marrow and spongiosafragments is examined in histological slides of lungs of 92 patients, after bone operations such as implantation of Thompson prothesis, femure neck nailing or Küntscher-nailing, and after injuries with bone fractures and in cases of extra-thoracic cardiac massage.

     
  2. 2.

    In decreasing frequency we find a) fat embolism in 50% of the cases, b) bone marrow embolism in 36,6% and c) bone fragment embolism in 12,6%.

     
  3. 3.

    The shorter the interval between operation or accident and the moment of death, the more frequent pulmonary embolism is present.

     
  4. 4.

    The fate of pulmonary embolism is as following: a) fat is dissolved, b) bone marrow may as well be dissolved or put into the intima as granuloma, c) spongiosa fragments are resorbed by osteoclasts of substituted by connective tissue.

     
  5. 5.

    Depending on its extent fat embolism may be lethal. Bone marrow embolism after severe fractures, too, may occlude many arteries of the lung and cause death. Embolism by bone fragments however is less common and does not cause death.

     
  6. 6.

    Methods to avoid or diminish embolism of bone marrow particles are a) bore holes in the distal fragment of fractured bones, b) immediate intervention in case of shock and c) controlled power in extrathoracic cardiac massage.

     

Key-Words

Fracture nailing Fat embolism Bone marrow embolism Bone fragment embolism 

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Copyright information

© Springer-Verlag 1970

Authors and Affiliations

  • L. Zichner
    • 1
  1. 1.Pathologisches Institut der Universität ZürichZürich/

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