**3. Epidemiology**

The reported incidence of FE & FES varies widely in literature. FE occurs in great majority of patients who sustain pelvic or long-bone fractures, endo-medullary nailing of longbone fractures or placement of knee and hip prosthesis. Embolic showers of circulating fat globules have been demonstrated in up to 41% of patients following surgical nailing of long bone fractures (Talbot & Schemitsch, 2006). However, only a small percentage of these patients develop FES (406th Medical General Laboratory, Professional Section, 1951; Deland, 1956; Gossling & Pellegrini, 1982; Gurd & Wilson, 1974; Koessler et al., 2001; Levy, 1990; Lozman et al., 1986; Palmovic & McCarroll, 1965; Peltier, 1969; Shier & Wilson, 1980; Talbot & Schemitsch, 2006). The incidence of posttraumatic FES can range from 0.25% (Peltier, 1969) to 35% (Gurd & Wilson, 1974; Lindeque et al., 1987; Riska & Myllynen, 1982). The timing of the fracture fixation also appears to impact the incidence of FES. Delayed surgery predisposes to a higher incidence. Non-traumatic FE or FES is rare.
