Kalbas Yannik, Seaver Thomas, Kumabe Yohei, Halvachizadeh Sascha, Lempert Maximilian, Pfeifer Roman, Marcantonio Andrew, Pape Hans-Christoph
Universitätsspital Zürich, Zürich, Switzerland.
Lahey Hospital & Medical Center, Burlington, MA, USA.
OTA Int. 2022 Apr 18;5(2 Suppl):e187. doi: 10.1097/OI9.0000000000000187. eCollection 2022 Apr.
Fat embolism and fat embolism syndrome (FES) remain common complications following long bone fractures. Incidence is highest after bilateral femur fractures. We performed a systematic review of FES after bilateral femur fractures and present two cases.
Systematic literature search of the Cochrane, EMBASE, MEDLINE, Scopus, and, Web of Science Library databases was performed in August 2021. Terms used including plural and alternate spellings: "fat embolism,""fat embolism syndrome,""fat embolus," and "bilateral femur fracture." Articles in German and English were considered. No time frame was applied.
Original studies, case series and case reports on fat embolism after bilateral femur fracture were included. Insufficient documentation or patients with relevant previous heath conditions were excluded.
Abstracts were organized using EndNote X9 by Carivate. Three authors independently screened the abstracts; cross check of the extracted data was performed by the senior author.
Scarcity of articles only allowed for a qualitative synthesis. Data was compared with our cases and situated within the scientific background.
Ten articles were included for qualitative synthesis ( = 144 patients). The symptoms were inhomogeneous with neurological deficits being most prominent. Degree of displacement was high, when reported. Although the modes and timing of surgery varied, this appeared unrelated with outcome.
FES remains a relevant complication after bilateral femur fractures, despite damage control strategies and improved reaming techniques. Fracture displacement and reduction maneuvers might play a more substantial role in the formation than previously accredited.
脂肪栓塞和脂肪栓塞综合征（FES）仍是长骨骨折后常见的并发症。双侧股骨骨折后的发病率最高。我们对双侧股骨骨折后的FES进行了系统评价，并报告两例病例。
2021年8月对Cochrane、EMBASE、MEDLINE、Scopus和Web of Science图书馆数据库进行了系统的文献检索。使用的检索词包括复数形式和交替拼写形式：“脂肪栓塞”“脂肪栓塞综合征”“脂肪栓子”和“双侧股骨骨折”。纳入德语和英语文章。未设定时间范围。
纳入关于双侧股骨骨折后脂肪栓塞的原始研究、病例系列和病例报告。排除记录不充分或有相关既往健康状况的患者。
摘要由科睿唯安公司的EndNote X9整理。三位作者独立筛选摘要；提取的数据由资深作者进行交叉核对。
文章稀缺，仅进行了定性综合分析。将数据与我们的病例进行比较，并置于科学背景下。
纳入10篇文章进行定性综合分析（n = 144例患者）。症状表现不一，以神经功能缺损最为突出。报告的移位程度较高。尽管手术方式和时间各不相同，但这似乎与预后无关。
尽管有损伤控制策略和改进的扩髓技术，FES仍是双侧股骨骨折后一个相关的并发症。骨折移位和复位操作在其形成过程中可能比之前认为地发挥更重要的作用。
4级。
