The American journal of orthopedics
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We present a case report of fat embolism syndrome (FES) that resulted in prolonged coma after cemented hemiarthroplasty in a patient with metastatic breast cancer. After the cemented hip prosthesis was placed, the patient developed decreased sensorium that progressed to coma in association with hypoxemia and tachypnea. Pulmonary compromise was mild, and the patient required only supplemental oxygen for support. ⋯ Magnetic imaging results were consistent with FES. While the pulmonary symptoms resolved quickly, the patient remained unresponsive for 11 days without purposeful motor function. After waking she recovered rapidly, and at her 2-month follow-up appointment, demonstrated no adverse orthopedic, pulmonary, or neurologic sequelae.
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Case Reports
Extraction of a supracondylar nail through the proximal femur during total hip arthroplasty.
With the increasing popularity of supracondylar femoral intramedullary nails, removal of these devices may become necessary during total hip arthroplasty. The present article describes a technique for extracting these nails in a retrograde fashion through the proximal femur, thus sparing the patient a knee arthrotomy.