[Fatal intraoperative lung fat embolism in endoprosthesis of the hip joint]

Report on 3 cases of intraoperative death during total hip replacement in treatment of transcervical fracture of the femur, using acrylic bone cement. The patients were two female (83 and 87 years-old) and one male (78 years old), who suffered from a sudden fall at home. Autopsy revealed massive fat embolism (FE) of the lung and in one case also in the other organs; in 2 cases this FE was the cause of death alone, in the third case together with an unusual severe coronary heart disease (heart weight 700 g). Discussion of the medico-legal aspects, i.e. the coincidence of FE of different causes (traumatic, by operation, by reanimation). Reflections on the certainty to attribute the death to specific (in particular deficient) technical factors.