Atypical presentation of fat embolism syndrome after gunshot wound to the foot.
Atypical presentation of fat embolism syndrome after gunshot wound to the foot.
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发表时间：
2015-03
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通讯作者：
Michael E Kralovec;M. Houdek;J. R. Martin;M. Morrey;William W. Cross
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作者：
Michael E Kralovec;M. Houdek;J. R. Martin;M. Morrey;William W. Cross
一名42岁男子脚部受枪伤，造成跗骨多处骨折。在6个小时的时间里，他变得迟钝，并开始出现呼吸系统损害和神经系统症状。在磁共振成像上，他被发现有无数的微小梗死，符合脂肪栓塞综合征。他被放置在一个跨越外固定器。患者在受伤后昏迷6周，但逐渐恢复功能。脂肪栓塞综合征通常被描述为长骨骨干损伤所致，但也可继发于足部创伤。在任何骨创伤的情况下，必须持续评估神经血管状态，当遇到神经功能缺损时，应保持高度怀疑。
A 42-year-old man sustained a gunshot wound to the foot, which caused multiple fractures of the tarsal bones. Over the course of 6 hours, he became obtunded and began to experience respiratory compromise and neurologic symptoms. On magnetic resonance imaging, he was found to have innumerable tiny infarcts consistent with fat embolism syndrome. He was placed in a spanning external fixator. The patient remained in a coma for 6 weeks after injury but gradually regained function. Fat embolism syndrome is classically described as resulting from injury to the diaphysis of a long bone, but it can occur secondary to trauma of the foot. Neurovascular status must be continually evaluated in the setting of any bony trauma, and index of suspicion should remain high when neurologic deficits are encountered.