Prevention of fat embolism syndrome in patients with femoral fractures--immediate or delayed operative fixation?

From January 1976 until August 1980, femoral fractures in our department were initially stabilized with tibial traction and fixed operatively after 4-7 days. From August 1980 the fractures were treated with immediate operative fixation. In this retrospective study, we compared the incidence of fat embolism syndrome in 106 patients treated with delayed operative fixation to the incidence in 114 patients treated with immediate operative fixation. Eleven patients (10.4%) developed fat embolism syndrome in the group treated with delayed fixation, compared with two patients (1.8%) in the immediate osteosynthesis group (p less than 0.02). We concluded that early operative fixation of femoral fractures seems beneficial for the prevention of fat embolism syndrome.