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FORTY-SEVENTH REPORT OF PROGRESS IN ORTHOPEDIC SURGERY

PHILIP D. WILSON, M.D.; M. N. SMITH-PETERSEN, M.D.; LLOYD T. BROWN, M.D.; JOHN G. KUHNS, M.D.; EDWIN F. CAVE, M.D.; SUMNER M. ROBERTS, M.D.; RALPH K. GHORMLEY, M.D.; JOSEPH E. MILGRAM, M.D.; JOSEPH A. FREIBERG, M.D.; GEORGE PERKINS
Arch Surg. 1932;24(6):1068-1081. doi:10.1001/archsurg.1932.01160180178011.
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Fat Embolism and Trauma.  —In an editorial in The Journal of The American Medical Association,27 it was stated that while the diagnosis of fat embolism was rarely made, the condition probably occurred with considerable frequency. It gave rise to two distinct clinical pictures. There was a pulmonary type characterized by symptoms of asphyxia before death. Here marked obstruction of the arterioles and capillaries of the lungs was observed. The second type, the cerebral type, showed signs of central nervous system irritation. In this type the fat emboli passed safely through the pulmonary circulation and caused lesions in the brain, heart and kidneys. The greatest incidence of fat embolism was observed in skeletal fractures, although this was probably less than 20 per cent. As much as 40 to 60 cc. of liquid fat was found mixed with blood about the broken ends of bones. Pulmonary fat embolism was more

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