A 32-year-old man sustains a closed fracture of the shaft of femur. Two days after skeletal traction, he develops sudden onset dyspnoea, petechiae over the chest and upper limbs, and confusion. Arterial blood gas shows PaO2 of 58 mmHg. Which complication has occurred?
- A Pulmonary embolism from deep vein thrombosis
- B Hypostatic pneumonia
- C Fat embolism syndrome ✓
- D Adult respiratory distress syndrome from fluid overload
Correct answer: C. Fat embolism syndrome
Explanation
Fat embolism syndrome classically presents 24–72 hours after long bone or pelvic fractures with the triad of respiratory distress, neurological dysfunction, and petechial rash over the chest, axillae, and conjunctivae. The petechiae distinguish it from pulmonary thromboembolism. Hypoxia is the most sensitive early sign, and a PaO2 below 60 mmHg is a major Gurd criterion.
Reference: Maheshwari Essential Orthopaedics, 6th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.