Why is it easy to suffer from acute pulmonary embolism after a simple movement after a fracture?

The disruption of the continuity and integrity of the bone is called a fracture, and it can be seen from the definition that no matter what type of fracture or what part of the fracture, the fracture itself does not cause death. But it is also true that some patients with fractures can cause embolism and death, what is going on?

Embolism is a complication of fractures, and fatal embolism mainly includes pulmonary embolism and cerebral embolism, but the nature of the two embolism is mostly different. Pulmonary embolism is mainly based on fat embolism, after the fracture of the medullary cavity is destroyed, fat droplets will first enter the venous sinus, and then with the venous return to the right heart, the right heart ejection into the lungs to cause fat embolism in the lungs, affecting the gas exchange of the lungs, and in severe cases, leading to death.

Cerebral embolism after fracture should be mainly hypovolemic cerebral embolism, not fat embolism as written in many textbooks. After the above-mentioned fracture, the fat droplets need to enter the lungs with venous blood first, and after gas exchange in the capillaries of the lungs, they enter the left heart, and the left heart will only reach the brain, and the capillaries of the lungs themselves are very thin, so the probability of fat droplets entering the brain again through the pulmonary capillaries is too low. Therefore, cerebral embolism after fracture is mainly caused by embolism and infarction caused by vasoconstriction in the brain caused by massive blood loss after fracture.

A severe fracture is an injury to the body itself, which can aggravate the pre-existing condition and lead to death. For example, elderly patients are prone to hip fractures, and the elderly often have more underlying internal diseases, and long-term bed rest after fracture leads to various bedridden complications, so the mortality rate of the elderly is as high as 30% within one year after hip fracture. Remind everyone that fractures are mostly caused by accidents, and it is especially important to pay attention to safety.

In addition to cerebral embolism and pulmonary embolism, the cause of death due to fracture may also be death from shock due to massive hemorrhage; neurogenic shock caused by pain; Severe infections are uncontrollable; Fractures in specific areas, such as multiple rib fractures, with paradoxical breathing that are not treated; Secondary damage to fractures, such as cervical spine fractures resulting in damage to the high spinal cord, etc. Embolism may occur in the elderly with thigh fractures, which may affect the function of many important organs in the body, and the elderly themselves are often combined with a variety of underlying diseases, so the condition is dangerous and the mortality rate is often high.

It is mainly because the tension of the intramedullary hematoma at the fracture site is too large, the bone marrow is destroyed, the fat droplets enter the ruptured static membrane fossa, and enter the blood circulation to cause fat embolism in the lungs or brain.

Because blood circulation becomes very slow after a fracture, and at the same time, the blood throughout the body is hypercoagulable due to trauma, so it is easy to suffer from acute pulmonary embolism.

Because after a fracture, the blood circulation will become very slow, and some blood will appear in a hypercoagulable state.