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November 22, 1965

Diagnosis and Treatment of Fat Embolism

Author Affiliations

From the Department of Orthopedic Surgery, the Cleveland Clinic Foundation, Cleveland.

JAMA. 1965;194(8):899-901. doi:10.1001/jama.1965.03090210063016

The occurrence of fat embolism as a complication of skeletal trauma has been of interest for more than a century. The controversy in regard to the source of the embolic fat has still not been resolved. The incidence of fat embolism is relatively high both on the battlefield and in civilian life (Table 1).1-7 The severity of this complication in association with multiple injuries, especially with fractures of long bones, is not generally appreciated. Systemic fat embolism produces a clinical syndrome with characteristic findings and pertinent laboratory results. With a better understanding of the underlying pathophysiological mechanisms, treatment has become more specific and less empirical.

Pathogenesis  The pathogenesis of fat embolism is still subject to conjecture and controversy. The genesis of the embolic fat is postulated as being either mechanical or physiochemical. Although it is possible that intravasation of fat into vascular channels can occur after trauma, recent studies8