SynthesisCanadian journal of surgery. Journal canadien de chirurgie2009
Do corticosteroids reduce the risk of fat embolism syndrome in patients with long-bone fractures? A meta-analysis.
Synthesis in Canadian journal of surgery. Journal canadien de chirurgie, 2009. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 50 papers, 2 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
50 citing papers in PubMed, 2 syntheses or guidelines pooled it, 118 citations in OpenAlex.
- Multisystemic involvement of post-traumatic fat embolism at a Pediatric Trauma Center: a clinical series and literature review.European journal of pediatrics · 2023Pooled it
- Cerebral fat embolism after traumatic bone fractures: a structured literature review and analysis of published case reports.Scandinavian journal of trauma, resuscitation and emergency medicine · 2021Pooled it
- Outcome of Multiple Combined Post-bariatric Surgery in Massive Weight Loss Patients.Aesthetic plastic surgery · 2026Article
- Fat Embolism Syndrome: A Case Series from a Single Tertiary Care Hospital.Journal of orthopaedic case reports · 2026Article
- Incidence, mortality, and factors associated with fat embolism syndrome in patients with long bone fractures at a trauma referral center in Bogotá, Colombia: 2016-2019 and 2022-2023.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2026Article
- Impact of dexamethasone treatment on hematological indicators in patients with fat embolism syndrome.European journal of medical research · 2026Article
- Advances and uncertainties in fat embolism syndrome: a review.Trauma surgery & acute care open · 2026Review
- Fat embolism syndrome following severe blunt chest trauma treated with veno-venous extracorporeal membrane oxygenation: A case report.Trauma case reports · 2025Article
- Suspected Fat Embolism Syndrome in the Setting of Ballistic Long Bone Fractures: A Case Report.Clinical practice and cases in emergency medicine · 2025Article
- Fat Embolism Syndrome Treated with Methylprednisolone.Internal medicine (Tokyo, Japan) · 2025Article
- Cerebral fat emboli monitoring using transcranial Doppler ultrasound and confirmation of a successful treatment response: a case report.Journal of trauma and injury · 2025Article
- Cerebral fat embolism following autologous fat injection in facial reconstruction: A case report.World journal of clinical cases · 2025Article
- Pathophysiology, clinical manifestations, and prognostic insights of cerebral fat embolism: a literature review.Frontiers in neurology · 2025Review
- Article
- Cerebral fat emboli in a patient with paraplegia caused by bilateral femur fractures.BMJ case reports · 2024Article
- Fat embolism: the hidden murder for trauma patients!Revista do Colegio Brasileiro de Cirurgioes · 2024Review
- Article
- Fat Pulmonary Embolism With Crazy-Paving Pattern Opacities and Pneumothorax: A Rare Complication of Liposuction.Cureus · 2023Article
- A Case of Fulminant Fat Embolism Syndrome With Very Early Onset After Femoral Neck and Sacral Fractures.Cureus · 2023Article
- Delayed presentation of fat embolism syndrome following elective total hip arthroplasty.BMJ case reports · 2022Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundFat embolism syndrome (FES) is a potentially lethal condition most commonly seen in polytrauma patients with multiple long-bone fractures. Treatment has centred around supportive care and early fracture fixation. Several small clinical trials have suggested corticosteroids benefit patients with FES, but this treatment remains controversial. Our objective was to determine the effect of corticosteroids in preventing FES in patients with long-bone fractures.
methodsWe conducted a meta-analysis of published studies of patients with long-bone fractures who were randomly assigned to groups receiving corticosteroids or standard treatment for the prevention of FES (1966-2006). Data were extracted on quality, population, intervention and outcomes. Our primary outcome was the development of FES. We used random-effects models to pool results across studies, assessing for study heterogeneity.
resultsOf the 104 studies identified, 7 met our eligibility criteria. Overall, the quality of the trials was poor. Our pooled analysis of 389 patients found that corticosteroids reduced the risk of FES by 78% (95% confidence interval [CI] 43%-92%) and that only 8 patients needed to be treated (95% CI 5-13 patients) to prevent 1 case of FES. Similarly, corticosteroids significantly reduced the risk of hypoxia. We found no differences in the rates of mortality or infection. Rates of avascular necrosis were not reported in any of these studies.
conclusionEvidence suggests that corticosteroids may be beneficial in preventing FES and hypoxia but not mortality in patients with long-bone fractures. The risk of infection is not increased with the use of corticosteroids. However, methodological limitations of these trials necessitate a large confirmatory randomized trial.
Indexed as
Identifiers
19865573PMC2769117W2167273724What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.