Introduction
Fat embolism is an abrupt disruption of the circulatory system commonly
caused by orthopedic trauma, which is shown physically by the appearance
of globules of fat in the vessels of the circulatory system. Fat
embolism syndrome is the systemic presentation of fat emboli in the
microcirculation, manifesting with the Gurd’s triad of respiratory
distress, neurological deficits, and petechial rashes [1,2].
According to the observations, pulmonary symptoms occur first, typically
24 to 72 hours after the trauma, but symptoms have been reported as
early as 12 hours, usually followed by neurological symptoms [2].
The exact occurrence of FES varies from 1% to 30%, as there are no
universal standards for diagnosis [3].
In 1861, Zenker was the first to conduct a clinical study of FES and
discovered fat droplets in the capillaries of the lungs of a railroad
worker who had died from a traumatic injury. However, despite Gauss’
mechanical explanation of FES in 1924 and Lehman and Moore’s biochemical
explanation in 1927, the concept of FES remains obscure [4].
Recent studies suggest that FES may have possible connections with
neurocognitive dysfunction and the development of deep vein thrombosis.
Clinical manifestations of FES vary widely and can include restlessness,
dyspnea, delirium, coma, and, in some cases, death. Case studies have
also highlighted the rare occurrence of FES in patients not resulting
from trauma, particularly during bone marrow removal, c-sections,
liposuction, lung transplants, and cosmetic surgeries [2].
There are many ways to prevent FES and other long bone fractures from
happening that have been discussed in the literature. Unfortunately,
there is no particular treatment for FES, so the main alternatives are
to give supportive care, although this is not a universal practice.
Damage control orthopedics (DCO) and optimizing reaming approaches have
been the principal management solutions for individuals with long bone
fractures. Although FES can be very dangerous, it is much less common
[5].
Here we present a case of a 23-year-old male who suffered a left both
bone closed fracture after an iron rod fell over his left lower limb. He
eventually developed the classic triad of Fat embolism syndrome after
being asymptomatic for 5 days following the trauma.