[Risk of fat embolism syndrome after intramedullary nailing in femoral fracture and thoracic injury].

Following the insertion of an intramedullary nail, the fat embolism is a frequent complication in patients with long bone fractures. The respiratory function of patients with fractures of the femur and accompanying severe chest injuries was improved. In general these patients have a high risk to develop a respiratory distress syndrome. The average age of the 22 polytrauma patients studied was 40 years. The injury's severity as assessed using the Hannover Polytrauma-Score (PTS) and the average score was 29 points. Using Suter's scoring system the severity of the respiratory distress syndrome was assessed (Table 3). The insertion of an intramedullary nail was performed on 18 patients. Four of them developed an ARDS (adult respiratory distress syndrome) up to grade IV for a period of 5 days. Two patients suffered an ARDS grade I for a period of 2 days. In the study no typical features of fat embolism syndrome were found in any of these patients.