Lee C, O'Hara NN, Conti B, et al. - A prospective observational study was conducted to correlate the volume of embolic load during intramedullary fixation of femoral and tibial shaft fractures. Researchers recruited a total of 23 patients for the study: 14 with femoral shaft fractures and 9 with tibial shaft fractures. All individuals had undergone continuous transesophageal echocardiography, and volume of the embolic load was evaluated during 5 distinct stages: postinduction, initial guidewire, reaming (REAM), nail insertion, and postoperative. They assessed the volume of embolic load based on previously described luminosity scores. A mixed-effects model was used to assess the embolic load based on fracture location and procedure stage. Compared with tibial shaft intramedullary nail (IMN) fixation, femoral shaft IMN fixation was correlated with a 215% increase in embolic load, with the greatest quantitative load during the REAM stage; nevertheless, both procedures produce embolic load.