• Gustavo Aparicio, Isabel Soler, and Luis López-Durán.
• Department of Orthopaedic Surgery, San Carlos University Hospital, Complutense University, c/Profesor Martín Lagos Avenue s/n, Madrid 28040, Spain. aparicio2201@gmail.com.
• BMC Res Notes. 2014 Apr 14; 7: 237.

BackgroundFat embolism syndrome is a potentially fatal complication of long bone fractures. It is usually seen in the context of polytrauma or a femoral fracture. There are few reports of fat embolism syndrome occurring after isolated long bone fractures other than those of the femur.Case PresentationWe describe a case of fat embolism syndrome in a 33-year-old Caucasian man. He was being seen for an isolated Gustilo's grade II open tibial fracture. He was deemed clinically stable, so we proceeded to treat the fracture with intramedullary reamed nailing. He developed fat embolism syndrome intraoperatively and was treated successfully.ConclusionThis case caused us to question the use of injury severity scoring for isolated long bone fractures. It suggests that parameters that have been described in the literature other than that the patient is apparently clinically stable should be used to establish the best time for nailing a long bone fracture, thereby improving patient safety.

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