A 28-year-old motorcyclist sustains a comminuted femur fracture. Intraoperative reaming of the medullary canal for IM nail insertion poses which of the following specific risks?
- A Avascular necrosis of femoral head
- B Fat embolism syndrome due to intravasation of medullary fat ✓
- C Compartment syndrome of the thigh
- D Sciatic nerve palsy
Correct answer: B. Fat embolism syndrome due to intravasation of medullary fat
Explanation
Reaming of the medullary canal generates high intramedullary pressure that can force fat and marrow contents into venous sinusoids, causing fat embolism syndrome — particularly dangerous in polytrauma patients with thoracic injury. This is the rationale for using unreamed (solid) nails or smaller reamers in high-risk patients. AVN of the femoral head would be a complication of the fracture itself or its blood supply disruption, not reaming of the shaft. Compartment syndrome and sciatic nerve palsy are not direct complications of reaming.
Reference: Maheshwari Essential Orthopaedics, 6th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.