Pell A C, Christie J, Keating J F, Sutherland G R
Edinburgh Royal Infirmary, Scotland, UK.
J Bone Joint Surg Br. 1993 Nov;75(6):921-5. doi: 10.1302/0301-620X.75B6.8245083.
We performed transoesophageal echocardiography on 24 patients during reamed intramedullary nailing of 17 tibial and seven femoral fractures. In 14 patients there was only minimal evidence of emboli passing through the heart, but in six copious showers of small emboli (< 10 mm maximum dimension) were observed. In four other patients, there were also multiple large emboli (> 10 mm maximum dimension). Three of these patients developed fat embolism syndrome postoperatively and one died. Earlier nailing was associated with smaller quantities of emboli.
我们对24例患者进行了经食管超声心动图检查，这些患者正在接受17例胫骨骨折和7例股骨骨折的扩髓髓内钉固定术。14例患者仅有极少的栓子通过心脏的证据，但6例患者观察到大量小栓子（最大直径<10mm）形成的栓子簇。另外4例患者还出现了多个大栓子（最大直径>10mm）。其中3例患者术后发生脂肪栓塞综合征，1例死亡。早期进行钉固定术与较少的栓子量相关。
