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題 名 | Fat Embolism Syndrome in Long Bone Fracture--Clinical Experience in a Tertiary Referral Center in Taiwan=長骨骨折後之脂肪栓塞症候群--臺灣一間醫學中心的臨床經驗 |
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作 者 | 蔡依樽; 許晉榮; 陳英豪; 馮逸卿; 許弘昌; 蔡俊灝; | 書刊名 | Journal of the Chinese Medical Association |
卷 期 | 73:8 2010.08[民99.08] |
頁 次 | 頁407-140+CA73 |
分類號 | 416.26 |
關鍵詞 | 併發症; 脂肪栓塞症候群; 股骨骨折; 長骨骨折; 脛骨骨折; Complication; Fat embolism syndrome; Femoral fracture; Long bone fracture; Tibial fracture; |
語 文 | 英文(English) |
英文摘要 | BACKGROUND: Fat embolism syndrome (FES) is a potentially fatal complication of long bone fractures. There have been no reports of FES in long bone fractures in this decade in Taiwan. The purpose of this study was to review the FES experiences in a tertiary referral center between January 1997 and February 2008. METHODS: Between January 1997 and February 2008, 13 patients with long bone fractures with documented FES in our institution were reviewed. FES was diagnosed clinically by at least 2 major criteria or 1 major with at least 4 minor signs of Gurd’s criteria. RESULTS: The incidences of FES, less than those reported in the literature, were 0.15% in fracture of the tibia, 0.78% in fracture of the femur and 2.4% in multiple fractures. The mortality rate of FES, similar to other available results, was about 7.7%. All cases were less than 35 years old, except for 1 70-year-old male. Fat embolism occurred within an average of 48.5 hours after long bone fracture. Eleven presented with sudden drop in hemoglobin level, dropping 4.2 g/dL on average. Nine presented with thrombocytopenia, and 10 presented with sudden drop in platelet count, dropping 140,000/dL on average. Two had cerebral sequelae without recovery at the last 48-month follow-up. CONCLUSION: This 12-year interval retrospective study revealed modern epidemiologic results for FES in long bone fracture. Compared with the available literature in the recent decade, the incidence of FES in long bone fracture in our institution is less and the mortality rate is similar. |
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