[Amputation level after frostbite: role of bone scan. A case report].

Abstract

BACKGROUND:

frostbite is defined as the damage sustained by tissues while subject to temperatures below their freezing point. The severity of tissue damage is variable, but frequently can result in amputation. Early surgical debridement is contraindicated in almost all patients because it can take weeks for definitive demarcation of non-viable tissues to occur. Bone scan is indicted in the evaluation of frostbite injuries and helps to establish the prognosis early.

CLINICAL CASE:

a 42 year old man suffered frostbite injury in the fingers and toes after more than 24 hours at 8,000 meters of altitude. The patient was treated with anticoagulant therapy and topical cures for six weeks. During this period, we performed two consecutive bone scan studies showing no changes in the level of vascularization. However, clinical improvement was important, devitalized tissues delimited to the level marked by the bone scan study, so amputation was performed.

CONCLUSION:

Because the bone scan remained invariable, we believe that could help us to determine the amputation level early without delaying surgery.

• Authors: Laura Ezquerra-Herrando, Eduardo Corella-Abenia, José María Zamora-Rodríguez, Jorge Albareda-Albareda, Javier Banzo-Marraco
• Journal: Cirugia y cirujanos (Cir Cir) 2013 Jul-Aug Vol. 81 Issue 4 Pg. 353-6 ISSN: 2444-054X [Electronic] Mexico
• Vernacular Title: Nivel de amputación tras lesiones por congelación: papel de la gammagrafía ósea. Reporte de un caso.
• PMID: 25063903 (Publication Type: Case Reports, Journal Article)

Chemical References

• Anticoagulants
• Radiopharmaceuticals
• Technetium Tc 99m Medronate

Topics

• Adult
• Amputation, Surgical (methods)
• Anticoagulants (therapeutic use)
• Combined Modality Therapy
• Debridement
• Ear, External (pathology)
• Finger Phalanges (diagnostic imaging)
• Fingers (blood supply, diagnostic imaging, pathology, surgery)
• Frostbite (diagnostic imaging, pathology, surgery)
• Humans
• Ischemia (prevention & control)
• Male
• Mountaineering
• Necrosis
• Nose (pathology)
• Radionuclide Imaging
• Radiopharmaceuticals
• Technetium Tc 99m Medronate
• Toe Phalanges (diagnostic imaging)
• Toes (blood supply, diagnostic imaging, pathology, surgery)