Acta chirurgica Scandinavica. Supplementum
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A special type of respiratory distress syndrome has been described in connection with fractures of the long bones, called fat embolism syndrome. In addition to the respiratory signs - tachypnoea, hypoxaemia and snow storm infiltrations in the chest x-ray films- the syndrome consists of petechiae, thrombocytopenia, cerebral disturbances, pyrexia etc. The respiratory insufficiency in this syndrome may be explained by a coagulation disorder, in which the release of tissue thromboplastins from the traumatized tissues results in an interstitial pneumonitis and peripheral thrombocytopenia. ⋯ Cautions handling and early stabilization of fractures reduce the tissue trauma and may thus reduce the manifestations of the fat embolism syndrome. Respiratory assistance is given when necessary, and most often the syndrome is self-resolving. Fulminant cases with increasing symptomatology are treated with methylprednisolone and respirator.