A case report on survival of a Polytrauma patient with Fat Embolism Syndrome treated by principles of Damage Control Orthopaedics and Intensive care

Bhaskar Borgohain; Kashif Akhtar Ahmed; Tashi Galen Khonglah; Wanlam K. Khongwir

Volume : X, Issue : IV, April - 2020

A case report on survival of a Polytrauma patient with Fat Embolism Syndrome treated by principles of Damage Control Orthopaedics and Intensive care

Bhaskar Borgohain, Kashif Akhtar Ahmed, Tashi Galen Khonglah, Wanlam K. Khongwir

Abstract :

In a patient with Polytrauma, the initial trauma (the first hit) and subsequent impact (a second hit) like a major open surgery, sepsis or an adverse event can lead to high risk of death. The principle of avoiding a second hit by minimum emergent surgical intervention to ensure return of stable physiological state in polytrauma is called “Damage Control Orthopaedics” (DCO). Severely injured patients are at risk of hypovolemic shock, Systemic Inflammatory Respone Syndrome(SIRS) and Multiple Organ failure(MOF). This is a report of a patient with polytrauma and an impending fat embolism syndrome which was recognised very early and management based on the principles of DCO. It is essential to recognise early the ominous clinical signs which indicate such poor physiological and biological status. In such cases, the risk for further deterioration can be reduced by a carefully staged management of major fractures with initial external fixation and secondary conversion to definitive procedures which prevents the burden of the second hit which is life threatening to such patients.