Study of preventive Effects of Methyl Prednisolone in Fat Embolism Syndrome on Patients with Fracture of Long Bones that will be done on 94 patients with closed fractures of tibia or femor during their admission in hospital.patients with skull,chest,lungs,pelvic,diaphragm,urogential injuries and... will be exclude.
patients will be placed in two 47 patients category randomizely by block randomization.
patients will be intravenousy injected by methylprednisolon or placebo(N/S)three times at the begining and then every 4 hours with the dosage of 10 mg/kg.All the patients will be examine at 0,12,24,72 hours after the admission and body temprature,heart rate,blood pressure, respiratory rate and Arterial blood gases will be mesured .outcomes we studies are based on lindeque criterias that includes respiratory parameters:1-pao2<60 mmhg 2-paco2>55 mmhg 3- respiratory rate>35 after good sedation 4-dyspnea,tachypnea..based on this criteria patients who has one or more of this parameters are diagnosed fat emboli syndrome