Abstract
1. Fat embolism occurs in a high percentage of all cases of injury and it is a relatively frequent complication of fractures of the long bones in civilian accidents as well as battle casualties.
2. The diagnosis can usually be established by the clinical features together with certain physical signs which must however be sought deliberately.
3. Important clinical features are the mental disturbance, alternation of coma with full consciousness, petechial haemorrhages in the conjunctiva and skin, and typical changes in the retina.
4. Evidence is still conflicting as to whether the fat arises by embolism from an injured bone, or by general metabolic disturbance.
5. The fat is harmful not so much by reason of mechanical obstruction of vessels as by erosion and rupture of the vessel wall clue to the liberation of fatty acids.
6. Preventive treatment appears to be of some value but no satisfactory specific treatment is yet available for the established case.
7. Ligation of the profunda vein has been tried in two patients, one of whom recovered and the other died.
