# Can a broken femur lead to Cardiac Arrest? **URL:** \ **Category:** Factual Questions\ **Created:** [September 1, 2012, 1:08pm UTC](https://boards.straightdope.com/t/can-a-broken-femur-lead-to-cardiac-arrest/633356 "2012-09-01T13:08:52Z")\ **Posts on this page:** 20\ **Page:** 1
**Author:** ![AK84](https://avatars.discourse-cdn.com/v4/letter/a/85e7bf/32.png) [@AK84](https://boards.straightdope.com/u/AK84)\ **Post date:** [September 1, 2012, 1:08pm UTC](https://boards.straightdope.com/t/can-a-broken-femur-lead-to-cardiac-arrest/633356/1 "2012-09-01T13:08:52Z")
I was having lunch with a person today and she mentioned that her father had suffered Cardiac Arrest after a fracture of his femur. Something to do with seepage of bone marrow…I find myself sceptical. Not that cardiac arrest happened (he was resuscitated) but that the femur was itself the cause. She is not a doctor nor am I. ---
**Author:** ![TruCelt](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/trucelt/32/523_2.png) [@TruCelt](https://boards.straightdope.com/u/TruCelt)\ **Post date:** [September 1, 2012, 1:13pm UTC](https://boards.straightdope.com/t/can-a-broken-femur-lead-to-cardiac-arrest/633356/2 "2012-09-01T13:13:02Z")
IANAD, but I seem to recall that’s how Finny died in “A Seperate Peace.” ---
**Author:** ![IvoryTowerDenizen](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/ivorytowerdenizen/32/17937_2.png) [@IvoryTowerDenizen](https://boards.straightdope.com/u/IvoryTowerDenizen)\ **Post date:** [September 1, 2012, 1:30pm UTC](https://boards.straightdope.com/t/can-a-broken-femur-lead-to-cardiac-arrest/633356/3 "2012-09-01T13:30:46Z")
Such a break can cause a fat embolism, which can cause death by blocking cardiac, pulmonary etc vessels. > **[Fat embolism syndrome](https://en.wikipedia.org/wiki/Fat_embolism)** > > Fat embolism syndrome occurs when fat enters the blood stream (fat embolism) and results in symptoms. Symptoms generally begin within a day. This may include a petechial rash, decreased level of consciousness, and shortness of breath. Other symptoms may include fever and decreased urine output. The risk of death is about 10%. > Fat embolism most commonly occurs as a result of fractures of bones such as the femur or pelvis. Other potential causes include pancreatitis, orthopedic surgery, bone marro... [http://www.medterms.com/script/main/art.asp?articlekey=116363](http://www.medterms.com/script/main/art.asp?articlekey=116363) ---
**Author:** ![Bozuit](https://avatars.discourse-cdn.com/v4/letter/b/edb3f5/32.png) [@Bozuit](https://boards.straightdope.com/u/Bozuit)\ **Post date:** [September 1, 2012, 1:34pm UTC](https://boards.straightdope.com/t/can-a-broken-femur-lead-to-cardiac-arrest/633356/4 "2012-09-01T13:34:00Z")
I think there was something in House where the issue was a broken bone “leaking” bone marrow. Not that House necessarily proves anything. ---
**Author:** ![Qadgop\_the\_Mercotan](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/qadgop_the_mercotan/32/83_2.png) [@Qadgop\_the\_Mercotan](https://boards.straightdope.com/u/Qadgop_the_Mercotan)\ **Post date:** [September 1, 2012, 3:29pm UTC](https://boards.straightdope.com/t/can-a-broken-femur-lead-to-cardiac-arrest/633356/5 "2012-09-01T15:29:21Z")
Yes, fat embolism, as noted by **IvoryTowerDenizen**. It’s a well-known potential complication of femur fractures. It even gets mentioned in a MASH episode. ---
**Author:** ![John\_Mace](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/john_mace/32/185_2.png) [@John\_Mace](https://boards.straightdope.com/u/John_Mace)\ **Post date:** [September 1, 2012, 3:33pm UTC](https://boards.straightdope.com/t/can-a-broken-femur-lead-to-cardiac-arrest/633356/6 "2012-09-01T15:33:48Z")
Wasn’t that what happened to Finny in _A Separate Peace_? ---
**Author:** ![eightysix](https://avatars.discourse-cdn.com/v4/letter/e/ecccb3/32.png) [@eightysix](https://boards.straightdope.com/u/eightysix)\ **Post date:** [September 1, 2012, 3:49pm UTC](https://boards.straightdope.com/t/can-a-broken-femur-lead-to-cardiac-arrest/633356/7 "2012-09-01T15:49:45Z")
Fat embolism is possiblity. If your friend specifically mentioned “seepage of bone marrow,” that is probably what she was referring to. Do you know if it was definitively diagnosed with an autopsy? Per my experience as a medical examiner, confirmed FE as a cause of death is really a zebra. Far far more common is just that the system gets sufficiently strained by the fracture that moderate or even mild preexisting comrbidities, such as heart disease, become significant enough that in combination with the injury they cause “cardiac arrest,” which after al is really just a synonym for death. ---
**Author:** ![Iggy](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/iggy/32/3364_2.png) [@Iggy](https://boards.straightdope.com/u/Iggy)\ **Post date:** [September 1, 2012, 4:39pm UTC](https://boards.straightdope.com/t/can-a-broken-femur-lead-to-cardiac-arrest/633356/8 "2012-09-01T16:39:15Z")
> [@eightysix](#): > > …Do you know if it was definitively diagnosed with an autopsy? … I hope not. The OP noted the patient was resuscitated. ---
**Author:** ![Kolak\_of\_Twilo](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/kolak_of_twilo/32/73_2.png) [@Kolak\_of\_Twilo](https://boards.straightdope.com/u/Kolak_of_Twilo)\ **Post date:** [September 1, 2012, 5:13pm UTC](https://boards.straightdope.com/t/can-a-broken-femur-lead-to-cardiac-arrest/633356/9 "2012-09-01T17:13:35Z")
I seem to recall a character dying from something like that in a novel I read in high school. ---
**Author:** ![Guinastasia](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/guinastasia/32/5751_2.png) [@Guinastasia](https://boards.straightdope.com/u/Guinastasia)\ **Post date:** [September 1, 2012, 5:17pm UTC](https://boards.straightdope.com/t/can-a-broken-femur-lead-to-cardiac-arrest/633356/10 "2012-09-01T17:17:05Z")
Could that possibly have what killed [Howie Morenz](http://en.wikipedia.org/wiki/Howie_Morenz#Final_game_and_death)? ---
**Author:** ![Jake](https://avatars.discourse-cdn.com/v4/letter/j/f475e1/32.png) [@Jake](https://boards.straightdope.com/u/Jake)\ **Post date:** [September 1, 2012, 5:44pm UTC](https://boards.straightdope.com/t/can-a-broken-femur-lead-to-cardiac-arrest/633356/11 "2012-09-01T17:44:11Z")
As I understand it, Mel Blanc fell out of his hospital bed (they forgot to put up the rails) and broke his femur. He died from it. (Go to YouTube, type in Mel Blanc, his bio is in there.) ---
**Author:** ![casdave](https://avatars.discourse-cdn.com/v4/letter/c/c6cbf5/32.png) [@casdave](https://boards.straightdope.com/u/casdave)\ **Post date:** [September 1, 2012, 8:02pm UTC](https://boards.straightdope.com/t/can-a-broken-femur-lead-to-cardiac-arrest/633356/12 "2012-09-01T20:02:23Z")
This is what killed a Formula One driver. > **[Ronnie Peterson](https://en.wikipedia.org/wiki/Ronnie_Peterson)** > > Bengt Ronnie Peterson (Swedish pronunciation: \[ˈrɔ̌nːɪ ˈpêtːɛˌʂɔn\]; 14 February 1944 – 11 September 1978) was a Swedish racing driver. Known by the nickname 'SuperSwede', he was a two-time runner-up in the Formula One World Drivers' Championship. > Peterson began his motor racing career in kart racing, traditionally the discipline where the majority of race drivers begin their careers in open-wheel racing. After winning a number of karting titles, including two Swedish titles in 1963 and 1964, ... ---
**Author:** ![Kent\_Clark](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/kent_clark/32/105_2.png) [@Kent\_Clark](https://boards.straightdope.com/u/Kent_Clark)\ **Post date:** [September 1, 2012, 8:14pm UTC](https://boards.straightdope.com/t/can-a-broken-femur-lead-to-cardiac-arrest/633356/13 "2012-09-01T20:14:22Z")
Political commentator and author Jeff Greenfield used it to kill off President-elect Foyle in his novel [The People’s Choice](http://en.wikipedia.org/wiki/The_People%27s_Choice_(novel)). ---
**Author:** ![Shamozzle](https://avatars.discourse-cdn.com/v4/letter/s/9f8e36/32.png) [@Shamozzle](https://boards.straightdope.com/u/Shamozzle)\ **Post date:** [September 2, 2012, 2:34am UTC](https://boards.straightdope.com/t/can-a-broken-femur-lead-to-cardiac-arrest/633356/14 "2012-09-02T02:34:56Z")
Also, a broken femur can subject a person to death by volume shock, no? ---
**Author:** ![AK84](https://avatars.discourse-cdn.com/v4/letter/a/85e7bf/32.png) [@AK84](https://boards.straightdope.com/u/AK84)\ **Post date:** [September 2, 2012, 1:48pm UTC](https://boards.straightdope.com/t/can-a-broken-femur-lead-to-cardiac-arrest/633356/15 "2012-09-02T13:48:44Z")
> [@Qadgop\_the\_Mercotan](#): > > . It’s a well-known potential complication of femur fractures. Ignorance fought! Thanks. Follow up. Why is the femur though? Is it because of the reletive size of the bone. ---
**Author:** ![Qadgop\_the\_Mercotan](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/qadgop_the_mercotan/32/83_2.png) [@Qadgop\_the\_Mercotan](https://boards.straightdope.com/u/Qadgop_the_Mercotan)\ **Post date:** [September 2, 2012, 2:03pm UTC](https://boards.straightdope.com/t/can-a-broken-femur-lead-to-cardiac-arrest/633356/16 "2012-09-02T14:03:53Z")
> [@AK84](#): > > Ignorance fought! Thanks. Follow up. Why is the femur though? Is it because of the reletive size of the bone. Biggest bone in the body, biggest marrow cavity in the body (except maybe for the pelvis, which doesn’t fracture and misalign so readily), with large veins right around it which can be gashed open by the bone shards and provide easy entrance to the vascular system for a fatty marrow embolism. ---
**Author:** ![ryanl](https://avatars.discourse-cdn.com/v4/letter/r/b487fb/32.png) [@ryanl](https://boards.straightdope.com/u/ryanl)\ **Post date:** [September 2, 2012, 5:35pm UTC](https://boards.straightdope.com/t/can-a-broken-femur-lead-to-cardiac-arrest/633356/17 "2012-09-02T17:35:51Z")
Actually, no fat embolism need be involved. Trauma that involves blood loss can potentially cause cardiac arrest. For example, suicide by wrist slashing often are ultimately caused by cardiac arrest induced by major blood loss. ---
**Author:** ![Qadgop\_the\_Mercotan](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/qadgop_the_mercotan/32/83_2.png) [@Qadgop\_the\_Mercotan](https://boards.straightdope.com/u/Qadgop_the_Mercotan)\ **Post date:** [September 2, 2012, 6:57pm UTC](https://boards.straightdope.com/t/can-a-broken-femur-lead-to-cardiac-arrest/633356/18 "2012-09-02T18:57:55Z")
> [@ryanl](#): > > Actually, no fat embolism need be involved. Trauma that involves blood loss can potentially cause cardiac arrest. For example, suicide by wrist slashing often are ultimately caused by cardiac arrest induced by major blood loss. But unless it’s an open femoral fracture, it’ll usually tamponade itself. There’s just not that much space to bleed into in the upper thigh. Leave a huge bruise, yes. Critical volume of blood lost? Maybe, maybe not. Here’s a few notes about fat embolism syndrome from UpToDate, a subscription medical website: > [@](#): > > SUMMARY > > Fat embolism syndrome (FES) may complicate a wide variety of clinical conditions. It is most commonly associated with long bone and pelvic fractures, and is more frequent in closed fractures than open fractures. > > Fat emboli may be the result of fat globules entering the bloodstream through tissue (usually bone marrow or adipose tissue) that has been disrupted by trauma or, alternatively, via production of the toxic intermediaries of plasma-derived fat (eg, chylomicrons or infused lipids). > > FES typically manifests 24 to 72 hours after the initial insult. The classic triad of findings includes hypoxemia, neurologic abnormalities, and a petechial rash. > > FES is a clinical diagnosis that can be made when the pathognomonic petechial rash occurs in an appropriate clinical setting. However, since the rash occurs in fewer than half of cases, the diagnosis is more commonly made when characteristic signs (ie, hypoxemia, respiratory insufficiency, neurologic impairment) occur in the appropriate clinical setting and no alternative explanation exists. > > There is no diagnostic test that is sufficiently sensitive or specific to be useful for confirming or excluding FES. ---
**Author:** ![Speaker\_for\_the\_Dead](https://avatars.discourse-cdn.com/v4/letter/s/c77e96/32.png) [@Speaker\_for\_the\_Dead](https://boards.straightdope.com/u/Speaker_for_the_Dead)\ **Post date:** [September 3, 2012, 2:06pm UTC](https://boards.straightdope.com/t/can-a-broken-femur-lead-to-cardiac-arrest/633356/19 "2012-09-03T14:06:27Z")
Just to provide final context, a large portion of our bone marrow is fat, especially as adults. That’s where the “fat embolus” comes from. It’s actually quite remarkable–in any orthopedic surgery that involves reaming out bones (e.g. hip replacements), the fluid that results looks like someone mixed melted butter into blood. As an aside, **Qadgop** , do you find _UptoDate_ useful? I have an awkward subscription through my remote-access to my hospital’s intranet, but I’m thinking of paying the $300 or whatever to get full access at home/on my phone. Would you recommend it? I remember liking it as a clerk, but I’m not sure how much I’ll use it as a resident. ---
**Author:** ![Qadgop\_the\_Mercotan](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/qadgop_the_mercotan/32/83_2.png) [@Qadgop\_the\_Mercotan](https://boards.straightdope.com/u/Qadgop_the_Mercotan)\ **Post date:** [September 3, 2012, 2:29pm UTC](https://boards.straightdope.com/t/can-a-broken-femur-lead-to-cardiac-arrest/633356/20 "2012-09-03T14:29:06Z")
> [@Speaker\_for\_the\_Dead](#): > > **Qadgop** , do you find _UptoDate_ useful? I recommend it highly. It’s enhanced my practice greatly, streamlining things and keeping me on top of important updates. It doesn’t waste my time with the latest studies, which have not really yet been incorporated into practice standards because there’s not been enough time yet to decide if the latest ‘breakthrough’ is meaningful or not. It tells me what standard practices are, and tells me when they change. [Next page](https://boards.straightdope.com/t/can-a-broken-femur-lead-to-cardiac-arrest/633356.md?page=2)