Fat Embolism and Related Effects During Reamed and Unreamed Intramedullary Nailing in a Pig Model

• Published in: Journal of orthopaedic trauma Vol. 16; no. 4; pp. 239 - 244
• Main Authors: Buttaro, M, Mocetti, E, Alfie, V, Paniego, G, Piñeiro, L
• Format: Journal Article
• Language: English
• Published: Hagerstown, MD Lippincott Williams & Wilkins, Inc 01-04-2002; Lippincott Williams & Wilkins
• Subjects: Animals; Biological and medical sciences; Blood and lymphatic vessels; Bone Marrow Examination; Brain - metabolism; Brain - pathology; Brain - physiopathology; Cardiology. Vascular system; Disease Models, Animal; Diseases of the peripheral vessels. Diseases of the vena cava. Miscellaneous; Embolism, Fat - etiology; Embolism, Fat - metabolism; Embolism, Fat - physiopathology; Femur - metabolism; Femur - physiopathology; Femur - surgery; Fracture Fixation, Intramedullary - adverse effects; Heart - physiopathology; Hemodynamics - physiology; Kidney - metabolism; Kidney - pathology; Kidney - physiopathology; Lung - metabolism; Lung - pathology; Lung - physiopathology; Male; Medical sciences; Myocardium - metabolism; Myocardium - pathology; Orthopedic surgery; Random Allocation; Respiratory Function Tests; Retina - metabolism; Retina - pathology; Retina - physiopathology; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Swine; Heart; Animal model; Retinopathy; Lung; Diseases of the osteoarticular system; Intramedullary nailing; Cardiovascular disease; Retina; Fracture; Kidney; Vascular disease; Heart disease; Surgery; Bone marrow; Complication; Ungulata; Kidney disease; Open reduction; Nervous system diseases; Urinary system disease; Fat embolism; Respiratory disease; Experimental study; Trauma; Cerebral disorder; Pig; Vertebrata; Mammalia; Treatment; Artiodactyla; Brain (vertebrata)
• ISSN: 0890-5339; 1531-2291
• DOI: 10.1097/00005131-200204000-00004

OBJECTIVESTo determine whether reamed or unreamed femoral intramedullary nailing is more adverse to pulmonary function, the authors compared three populations of healthy pigs, analyzing the biochemical and hemodynamic effects related to fat embolism. Likewise, the authors histologically evaluated the presence of bone marrow fat embolism in lungs, heart, kidney, brain, and retina.
DESIGNRandomized, experimental model.
SETTINGLaboratory.
PARTICIPANTSTwenty-five male Duroc Jersey adult healthy pigs divided in three groups.
INTERVENTIONReamed and unreamed intramedullary nailing.
OUTCOME MEASUREMENTSBiochemical, hemodinamical, and histologic analysis.
METHODSIn the first group of ten pigs, a reamed nail was inserted; in the second group of ten specimens, the authors placed an unreamed nail; and in the third group of five animals (control), only the surgical approach was made without opening the medullary cavity.
RESULTSThe authors did not find statistically significant differences in pulmonary function between the reamed and unreamed group in the hemodynamic, biochemical, and histopathologic parameters evaluated. The histologic analysis of the lung tissue revealed a statistically significant difference between the nailed groups and the control (P < 0.04).
CONCLUSIONSIn this animal model, the results indicate that pulmonary changes and fat embolization during intramedullary nailing occur to the same degree in reamed and in unreamed femurs.