Fatal fat embolism following replacement arthroplasty for transcervical fractures of femur

Seven cases are reported of death in old people associated with transcervical fractures of the femur and occurring shortly after insertion of a Thompson prosthesis. They are compared with six fatalities following similar injury but not surgically treated and with three which followed internal fixation. Positive controls for massive fat embolism were selected from fatal cases of multiple and severe skeletal fractures due to road accidents.It seems likely that patients undergoing this operation are peculiarly susceptible to lethal fat embolism. The clinical features, diagnosis, pathological aspects, and prevention of fat embolism are discussed.