Fat Embolism in Non-Orthopedic Contexts: A Literature Review of Clinical Cases and Pathophysiology(Review Article)

Chaghamirzayi, Pouria; Najafi, Arvin; Azarsina, Salman; Karimi Rozveh, Javad; Hadavi, Dorsa; Hadi Bahri, Mohamad; Azizmanesh, Mohammad; Tiotour, Mehdi

doi:10.22034/ijos.2025.552137.1180

Fat Embolism in Non-Orthopedic Contexts: A Literature Review of Clinical Cases and Pathophysiology(Review Article)

Document Type : Review

Authors

Pouria Chaghamirzayi ¹ ^¶

Arvin Najafi ² ^¶

Salman Azarsina ²

Javad Karimi Rozveh ¹

Dorsa Hadavi ¹

Mohamad Hadi Bahri ³

Mohammad Azizmanesh ¹

Mehdi Tiotour ²

¹ Clinical Research Development Unit of Shahid Madani Hospital, Alborz University of Medical Sciences, Karaj, Iran.

² Department of Orthopedic Surgery, Clinical Research Development Unit of Shahid Madani Hospital, Alborz University of Medical Sciences, Karaj, Iran.

³ Department of General Surgery, Clinical Research Development Unit of Shahid Madani Hospital, Alborz University of Medical Sciences, Karaj, Iran.

https://doi.org/10.22034/ijos.2025.552137.1180

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.

Keywords

Fat embolism

Liposuction

Organ transplantation

Hemoglobinopathies

Subjects