Fractures & Trauma · NEET PG Preparation Orthopaedics
A 24-year-old male is brought to the emergency department following a high-speed motor vehicle collision. He has a closed fracture of the shaft of th…
Practice question from Fractures & Trauma (NEET PG Preparation Orthopaedics), with the correct answer and a step-by-step solution.
medium · MCQ · Q-8D1FD0
A 24-year-old male is brought to the emergency department following a high-speed motor vehicle collision. He has a closed fracture of the shaft of the femur. Over the next 24 hours, he develops confusion, petechial rashes over the anterior chest wall and axilla, and acute respiratory distress. Arterial blood gas analysis reveals hypoxemia. Which of the following is the most definitive early preventative measure for this complication?
- A.Administration of high-dose systemic corticosteroids
- B.Early stabilization and intramedullary nailing of the femoral fractureCorrect answer
- C.Prophylactic placement of an inferior vena cava filter
- D.Immediate therapeutic anticoagulation with low-molecular-weight heparin
Solution
The patient's clinical presentation of confusion, petechiae, and respiratory distress following a long bone fracture is classic for Fat Embolism Syndrome (FES). The most effective way to prevent FES is early immobilization/stabilization of the long bone fractures, which minimizes the release of marrow fat into the venous circulation.
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