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Osteosynthesis and Trauma Care 2004; 12(3): 140-144
DOI: 10.1055/s-2004-822778
Original Article

© Georg Thieme Verlag Stuttgart · New York

A Study of the Pathway of Marrow Fat Intravasation during Intramedullary Reaming

N.-M. Cheung1 , W.-H. Cheung1 , K.-S. Leung1
  • 1Department of Orthopaedics and Traumatology, The Chinese University of Hong Kong, Hong Kong, China
Further Information

Publication History

Publication Date:
06 September 2004 (online)

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Abstract

Marrow fat intravasation is common after intramedullary reaming. However, the pathway of marrow fat entering into the systemic circulation has not been completely documented. The present study was designed to study the pathway of marrow fat intravasation during intramedullary reaming and the related clinical implications with an animal model. Five goats were subjected to intramedullary reaming and 3 goats received skin incisions as control. Real-time changes of intramedullary pressure were measured during reaming. Osseous and pulmonary tissues were studied histologically at the end of the experiment. The intramedullary pressure reached 565 ± 198 mmHg at the first reaming. Marrow fats were found inside the Haversian canals, Volkmann canals, osteocytic lacunae, periosteal vessels, extraosseous vessels and pulmonary circulation in all animals with reaming. In contrast to the common belief that marrow fat directly goes to the vascular system from the marrow cavity, this study documents the pathway of marrow fat intravasation via intracortical canaliculi. This finding could explain the pathogenesis of pulmonary fat embolism after reaming of a non-fractured intramedullary canal.

Key words

Marrow fats - Haversian canal - Volkmann canal - osteocytic lacunae - periosteal vessel - pulmonary circulation

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Professor Kwok-Sui Leung

Department of Orthopaedics and Traumatology · The Chinese University of Hong Kong

Hong Kong

P. R. China

Phone: +8 52/26 32-27 24

Fax: +8 52/26 37-78 89

Email: ksleung@cuhk.edu.hk

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