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: Distal radius fractures are the most common fractures in the upper limb, and many studies have been conducted on its treatment. There is, as yet, no consensus on which treatment method is preferable. This paper compares the use of plate alone with plate + external fixator in this fracture.
Materials & Methods: In a randomized clinical trial (RCT), patients with type C2 and C3.1(AO/OTA classification) distal radius fracture, were randomly divided into two groups of fixation with locking plate alone (control) and fixation with plate and additional external fixator (intervention). Then patients were evaluated in terms of radiographs and clinical outcomes in first, third and, sixth weeks, and also 6 and 9 months after surgery by Quick Disabilities of the Arm, Shoulder and Hand questionnaire (qDASH) and visual analogue score (VAS). SPSS software was used for data analysis. Informed consent was obtained from the patients.
Results & Discussion: 52 patient (26 in each group) were enrolled in the study. The mean age was 42 years in the control and 41 years in the intervention group. The qDASH score in the control group was 35 and 38 in the intervention group and this difference was not significant between the two groups. No significant difference was observed between the two groups in terms of pain level according to the (VAS) score either. Also, the radiographic criteria including radius height and palmar tilt, did not differ significantly between the two groups (p<0.05).
Conclusion: In general, with similar results of plating, and plating with addition of external fixator in fixation of distal radius fracture, the method of “plate alone” is preferred.