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It would be an interesting audit if > anyone > is having enough FES to do it. > > Matt Dunn > > Sounds like a perfect topic for a country-wide audit - perhaps co-ordinated by TARN as they probably have enough hospitals. Failing that, paging John Ryan - a regional audit topic for SE Thames? As to Gautam's question about the genesis of it, there have been studies done to look at the femoral vein with U/S and also with TOE which show showers of debris coming back from the lower limbs /during/ reaming and nailing procedures. This has been taken to mean that the surgery itself causes FES, but it may be simply a "hypoxic syndrome 2 days after trauma" variant of ARDS (itself a nasty nebulous concept consisting of a group of disease processes resulting a final common pathway of lung infiltrates and hypoxia) and early fixation of limbs may, as the orthopaedic registrar comments, be reduced by early fixation. Certainly in the present state of the NHS these are often left to the next day before fixing and sometimes even longer, and a New Zealand nurse working with us at the moment also says that they try and fix femurs in 2 hours in the Antipodes, and that FES is rare there. Best wishes, Rowley Cottingham [log in to unmask] %%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%