Key messages

• Fat embolism syndrome is the most common cause of death secondary to long-bone and pelvic fractures.

• The classic triad of respiratory distress, petechial rash, and neurological function is diagnostic of fat embolism syndrome.

• Young males with long-bone fractures are most at risk, and such patients demand awareness and a high index of suspicion.

• Management is largely supportive and is aimed at maintaining an adequate PO2, if necessary by advanced techniques such as positive end-expiratory syndrome.

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