A 28-year-old woman develops fat embolism syndrome 36 hours after an intramedullary nailing of a closed femoral shaft fracture. The classic triad of fat embolism syndrome includes:

• A Fever, tachycardia, and hypotension (Virchow's triad)
• B Petechiae, respiratory failure, and neurological dysfunction ✓
• C Joint swelling, hemarthrosis, and fat globules in urine
• D Hypercalcaemia, hyperlipidaemia, and acute kidney injury

Explanation

The Gurd and Wilson clinical criteria for fat embolism syndrome require at least one major criterion: respiratory failure (PaO2 <60 mmHg), petechial rash (axillary, chest, conjunctival), or cerebral involvement (confusion, drowsiness). The classic triad is petechiae, hypoxaemia (ARDS-like picture), and neurological dysfunction. It occurs 24–72 hours post-injury and is most common after long bone fractures, especially femur. Treatment is supportive (oxygen, mechanical ventilation if needed); early fracture fixation reduces incidence.

Reference: Maheshwari Essential Orthopaedics, 6th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.