Talucci R C, Manning J, Lampard S, Bach A, Carrico C J
Am J Surg. 1983 Jul;146(1):107-11. doi: 10.1016/0002-9610(83)90269-6.
Results of our retrospective review of 100 consecutive patients show that early intramedullary nailing can be accomplished in severely injured patients without increasing the risk of fat embolism syndrome. No cases of fat embolism syndrome were seen after immediate (less than 24 hours) intramedullary nailing of femoral shaft fractures. In contrast, five cases of fat embolism syndrome were found in the patients treated in the traditional manner with initial balanced skeletal traction and delayed intramedullary nailing. There was a trend toward more pulmonary complications in the immediate group. This is attributed to the greater severity of injury present in the patients selected for immediate intramedullary nailing (injury severity scores 23.2 in immediate group; 12.4 in delayed group). The incidence of critical hypoxemia in the immediate group was equivalent to that in another group of injured patients who did not have fractures, but who did have similar injury severity scores.
我们对100例连续患者进行回顾性研究的结果表明，在严重受伤的患者中可以早期进行髓内钉固定，而不会增加脂肪栓塞综合征的风险。股骨干骨折后立即（少于24小时）进行髓内钉固定后未出现脂肪栓塞综合征病例。相比之下，在采用初始平衡骨骼牵引和延迟髓内钉固定的传统治疗方式的患者中发现了5例脂肪栓塞综合征病例。立即手术组有出现更多肺部并发症的趋势。这归因于选择立即进行髓内钉固定的患者损伤更严重（立即手术组损伤严重程度评分为23.2；延迟手术组为12.4）。立即手术组严重低氧血症的发生率与另一组没有骨折但损伤严重程度评分相似的受伤患者相当。
