pulmonary effects of fixation of a fracture with a plate compared with intramedullary nailing. a...

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Pulmonary Effects of Fixation of a Fracture with a Plate Compared with Intramedullary Nailing. A Canine Model of Fat Embolism and Fracture Fixation* by EMIL H. SCHEMITSCH, RINA JAIN, DIANA C. TURCHIN, J. BRENDAN MULLEN, ROBERT J. BYRICK, GAIL I. ANDERSON, and ROBIN R. RICHARDS J Bone Joint Surg Am Volume 79(7):984-96 July 1, 1997 ©1997 by The Journal of Bone and Joint Surgery, Inc.

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Page 1: Pulmonary Effects of Fixation of a Fracture with a Plate Compared with Intramedullary Nailing. A Canine Model of Fat Embolism and Fracture Fixation* by

Pulmonary Effects of Fixation of a Fracture with a Plate Compared with Intramedullary Nailing. A Canine Model of

Fat Embolism and Fracture Fixation*

by EMIL H. SCHEMITSCH, RINA JAIN, DIANA C. TURCHIN, J. BRENDAN MULLEN, ROBERT J. BYRICK, GAIL I. ANDERSON, and ROBIN R. RICHARDS

J Bone Joint Surg AmVolume 79(7):984-96

July 1, 1997

©1997 by The Journal of Bone and Joint Surgery, Inc.

Page 2: Pulmonary Effects of Fixation of a Fracture with a Plate Compared with Intramedullary Nailing. A Canine Model of Fat Embolism and Fracture Fixation* by

Fig. 1-A, 1-B, and 1-C: Radiographs showing the three methods used for fixation of the fracture of the right canine femur.

EMIL H. SCHEMITSCH et al. J Bone Joint Surg Am 1997;79:984-96

©1997 by The Journal of Bone and Joint Surgery, Inc.

Page 3: Pulmonary Effects of Fixation of a Fracture with a Plate Compared with Intramedullary Nailing. A Canine Model of Fat Embolism and Fracture Fixation* by

Fig. 1-B: Fixation with an intramedullary nail (4.5 by 150.0 millimeters) without reaming.

EMIL H. SCHEMITSCH et al. J Bone Joint Surg Am 1997;79:984-96

©1997 by The Journal of Bone and Joint Surgery, Inc.

Page 4: Pulmonary Effects of Fixation of a Fracture with a Plate Compared with Intramedullary Nailing. A Canine Model of Fat Embolism and Fracture Fixation* by

Fig. 1-C: Fixation with an intramedullary nail (8.0 by 150.0 millimeters) with reaming.

EMIL H. SCHEMITSCH et al. J Bone Joint Surg Am 1997;79:984-96

©1997 by The Journal of Bone and Joint Surgery, Inc.

Page 5: Pulmonary Effects of Fixation of a Fracture with a Plate Compared with Intramedullary Nailing. A Canine Model of Fat Embolism and Fracture Fixation* by

Fig. 2-A, 2-B, and 2-C: Photomicrographs of histological specimens, after staining with osmium tetroxide, demonstrating embolic fat (arrows).

EMIL H. SCHEMITSCH et al. J Bone Joint Surg Am 1997;79:984-96

©1997 by The Journal of Bone and Joint Surgery, Inc.

Page 6: Pulmonary Effects of Fixation of a Fracture with a Plate Compared with Intramedullary Nailing. A Canine Model of Fat Embolism and Fracture Fixation* by

Fig. 2-B Specimen from a brain (x 200).

EMIL H. SCHEMITSCH et al. J Bone Joint Surg Am 1997;79:984-96

©1997 by The Journal of Bone and Joint Surgery, Inc.

Page 7: Pulmonary Effects of Fixation of a Fracture with a Plate Compared with Intramedullary Nailing. A Canine Model of Fat Embolism and Fracture Fixation* by

Fig. 2-C Specimen from a kidney (x 200).

EMIL H. SCHEMITSCH et al. J Bone Joint Surg Am 1997;79:984-96

©1997 by The Journal of Bone and Joint Surgery, Inc.

Page 8: Pulmonary Effects of Fixation of a Fracture with a Plate Compared with Intramedullary Nailing. A Canine Model of Fat Embolism and Fracture Fixation* by

Fig. 3 Line graph showing pulmonary artery pressure (PAP) over time in the group in which the fracture was fixed at four hours.

EMIL H. SCHEMITSCH et al. J Bone Joint Surg Am 1997;79:984-96

©1997 by The Journal of Bone and Joint Surgery, Inc.

Page 9: Pulmonary Effects of Fixation of a Fracture with a Plate Compared with Intramedullary Nailing. A Canine Model of Fat Embolism and Fracture Fixation* by

Fig. 4 Line graph showing pulmonary artery pressure (PAP) over time in the group in which the fracture was fixed at twenty-four hours.

EMIL H. SCHEMITSCH et al. J Bone Joint Surg Am 1997;79:984-96

©1997 by The Journal of Bone and Joint Surgery, Inc.

Page 10: Pulmonary Effects of Fixation of a Fracture with a Plate Compared with Intramedullary Nailing. A Canine Model of Fat Embolism and Fracture Fixation* by

Fig. 5 Bar graph showing the alveolar-arterial PO2 gradients over time in the group in which the fracture was fixed at four hours.

EMIL H. SCHEMITSCH et al. J Bone Joint Surg Am 1997;79:984-96

©1997 by The Journal of Bone and Joint Surgery, Inc.

Page 11: Pulmonary Effects of Fixation of a Fracture with a Plate Compared with Intramedullary Nailing. A Canine Model of Fat Embolism and Fracture Fixation* by

Fig. 6 Bar graph showing the alveolar-arterial PO2 gradients over time in the group in which the fracture was fixed at twenty-four hours.

EMIL H. SCHEMITSCH et al. J Bone Joint Surg Am 1997;79:984-96

©1997 by The Journal of Bone and Joint Surgery, Inc.