DeFroda Steven F, Klinge Stephen A
Department of Orthopaedics, Warren Alpert Medical School, Brown University, Providence, RI.
Am J Orthop (Belle Mead NJ). 2016 Nov/Dec;45(7):E515-E521.
Fat embolism syndrome (FES) is a well-known sequela of long-bone fracture and fixation. FES most commonly affects the pulmonary system. Brain emboli may lead to a symptomatic cerebral fat embolism (CFE), which is devastating. In this article, we review the presentation, causes, and management of FES presenting with CFE, report a case, and review the literature. The case involved an otherwise healthy 42-year-old woman who developed CFE after reamed intramedullary nail fixation of femoral and tibial shaft fractures during a single operation. When the patient presented after surgery, she was nonverbal and was having diffuse extremity weakness. The diagnosis was stroke and resultant diffuse encephalopathy secondary to CFE. Within days of urgent management, the patient's cognitive and ophthalmologic deficits were substantially improved. Six months after surgery, cognitive and ophthalmologic recovery was excellent, and the fractures were healing with good functional recovery in the affected limb.
脂肪栓塞综合征（FES）是长骨骨折及固定术后一种广为人知的后遗症。FES最常累及肺部系统。脑栓塞可能导致有症状的脑脂肪栓塞（CFE），这是极具破坏性的。在本文中，我们回顾了伴有CFE的FES的临床表现、病因及治疗，报告了1例病例，并对相关文献进行了综述。该病例为一名42岁的健康女性，在一次手术中对股骨干和胫骨干骨折行扩髓髓内钉固定术后发生了CFE。患者术后就诊时不能言语，且四肢弥漫性无力。诊断为中风及继发于CFE的弥漫性脑病。在紧急治疗数天内，患者的认知和眼科缺陷有了显著改善。术后6个月，认知和眼科功能恢复良好，骨折正在愈合，患肢功能恢复良好。
