Abstract / Summary
Background: Fat embolism is a clinically significant condition characterized by systemic fat dissemination, often leading to life-threatening complications. Traditionally associated with trauma, FE is increasingly recognized in diverse contexts, including orthopedic and aesthetic procedures. Despite extensive investigation, essential gaps remain regarding its pathophysiology, diagnostic approaches, and targeted treatments. Methods: Following PRISMA guidelines, we systematically reviewed experimental studies on FE published in PubMed and Embase from Jan 2000 to May 2026. Eligible studies investigated (1) models of fat embolism pathophysiology, (2) orthopedic or aesthetic procedure–related fat embolism, and (3) diagnostic or management strategies. Human studies and inaccessible full texts were excluded. Of the 3395 records identified, 100 met the inclusion criteria after duplicate removal (n = 744) and screening (n = 2651). Data extraction was conducted independently by four reviewers, with disagreements resolved by consensus. Results: One hundred experimental studies were included. Findings demonstrated that fat embolism develops through two mechanisms: vascular obstruction and systemic inflammation. Orthopedic procedures and aesthetic interventions significantly increase the risk of embolism. Advanced imaging modalities, such as dual-energy CT, and biomarkers, particularly IL-6, improved detection. Targeted therapies, including NLRP3 inflammasome inhibitors and renin–angiotensin modulators, reduced lung injury and improved survival in severe cases. Discussion: This review integrates mechanistic insights into the biphasic injury patterns and organ-specific vulnerabilities of fat embolism. Preventive procedural strategies may reduce risk, while novel diagnostics and targeted pharmacological approaches show translational potential. Limitations include methodological heterogeneity across studies.