Iranian Journal of Orthopedic Surgery

Abstract Abstract
Fat embolism syndrome (FES) is traditionally associated with orthopedic trauma, particularly long bone fractures, but its occurrence in non-orthopedic contexts, such as cosmetic procedures, acupuncture, and other minimally invasive interventions, is emerging as a significant clinical concern.
This literature review explores the clinical cases, pathophysiology, and knowledge gaps related to fat embolism in these non-orthopedic settings. The review, mostly includes the articles from the last 14 years.
The review synthesizes existing case reports, highlighting the mechanisms by which fat globules enter the bloodstream, often through tissue disruption in fat-rich areas. While fat embolism is well-documented in orthopedic trauma, the risk in non-traumatic contexts remains underrecognized, with diagnostic challenges and limited understanding of the precise mechanisms involved. Procedures like liposuction, gluteal fat grafting, and acupuncture have been implicated in fat embolism, often resulting in severe complications such as respiratory distress and neurological impairment. Despite the rising frequency of these procedures, significant gaps remain in understanding risk factors, improving diagnostic techniques, and optimizing treatment strategies.
This review underscores the need for increased awareness and further research to understand non-orthopedic fat embolism better, refine diagnostic approaches, and develop preventive measures to reduce the risk of complications in clinical practice.

Abstract Abstract
Introduction: The aim of this study is to investigate the radiographic and clinical findings in patients before and after Smith-Peterson osteotomy to correct adult spine deformity.
Materials & Methods: This is a case series study. Data be prepared and extracted retrospectively from patients' records. Inclusion criteria were age >18 years, American Society of Anesthesiology (ASA) risk class III or less, and sagittal spine deformity within three years. All the patients had pre-operative full standing digital spine radiography. Radiographic and clinical parameters were extracted from the patients' files before the operation and 1 month after the operation. Demographic and surgical and clinical information: information was obtained for each patient. The information from the questionnaire was coded and entered SPSS software. The level of significance was considered less than 5%.
Results & Discussion: A total of 10 patients met the conditions for entering the study and were examined. The amount of change in SAV before and after correction of deformity post-surgery decreased significantly (P<0.0001), the amount of Pelvic Incidence increased from 51.7 to 52.5 after surgery, which is not statistically significant(p=0.269). Pelvic tilt decreased from 28.7 to 23.5 after surgery (P=0.002). Sacral slope increased from 23.5 to 29.4 (p=0.002). Lumbar Lordosis also increased from 8.5 to 42.1 after surgery (p<0.0001). The rate of Thoracic Kyphosis also increased significantly from 24.4 to 25.2 after surgery (P=0.003). There was a significant decrease in VAS from 7.7 to 3.1 after surgery (P<0.00001).
Conclusion: The spinal deformity correction by the Smith-Peterson osteotomy method can improve the radiographic as well as clinical parameters in short term.

Abstract Abstract
This case report outlines the situation of a young woman suffering from intense back pain, along with pelvic tilt and rotation. Due to the extent of her postural deformity and the profound effect on her quality of life, a spinopelvic fixation was performed to, halt any progression of the deformity, and relieve her pain. During the procedural process, a mass was detected in the sacral area. It was, later found that her vagina had two separate openings, putting the case in the syndromic sacral agenesis group. The importance of genetic testing, multi-disciplinary evaluation and significance of continued follow-u and care is high-lighted.