The changes in a number of haemostatic factors after fractures of the tibia or femur were compared with those observed in patients with fat embolism complicating such fractures. After fractures uncomplicated by fat embolism there was a rise in the fibrinogen, α1-antitrypsin and serum activation inhibitor. The plasminogen level and platelet count initially fell, but later increased to above the initial levels. Patients whose fractures were complicated by fat embolism had the same pattern of changes but quantitatively greater.
1. Epiphysial tilt commonly precedes slipping. 2. This tilt is due to a diminished or arrested growth from compression of the back of the epiphysial plate. 3. The stresses on the upper end of the femur are such that the upper femoral epiphysial plate is peculiarly liable to compression. 4. A primary abnormality of the cartilage of the epiphysial plate renders it susceptible to the effect of compression. 5. Because this abnormality is diffuse, deformities due to a similar pathology may be found elsewhere, notably in the spine.
