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>Journals >Cirugía y Cirujanos >Year 2013, Issue 4


Ezquerra-Herrando L, Corella-Abenia E, Zamora-Rodríguez JM, Albareda-Albareda J, Banzo-Marraco J
Amputation level after frostbite: role of Bone Scan. A case report
Cir Cir 2013; 81 (4)

Language: Español
References: 17
Page: 353-356
PDF: 275.47 Kb.

[Full text - PDF]

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 years old man suffers frostbite injury in the fingers and toes after more than 24 hours at 8,000 meters of altitude. The patient is treated with anticoagulant therapy and topical cures for six weeks. During this period, we practice two consecutive bone scan studies showing no changes in the level of vascularization. However, clinical improvement is important, devitalized tissues delimit to the level marked by the bone scan study, so amputation is performed.
Conclusion: like bone scan remained invariable, we believe that can help us to determine amputation level early without delaying surgery.


Key words: frostbite, bone scan, amputation level.


REFERENCES

  1. Francis TJR, Oakley EHN. Cold Injury. In: Tooke JE, Lowe GDO editors. A textbook of vascular medicine. London: Hodder Arnorld, 1996;353-370.

  2. Golant A, Nord RM, Paksima N, Posner MA. Cold Exposure Injuries to the Extremities. J Am Acad Orthop Surg 2008;16:704-715.

  3. Murphy JV, Banwell PE, Roberts AHN, McGrouther DA. Frostbite: Pathogenesis and Treatment. J Trauma 2000;48:171-178.

  4. Bruen KJ, Gowski WF. Treatment of digital frostbite: current concepts. J Hand Surg Am 2009;34:553-554.

  5. McIntosh SE, Hamonko M, Freer L, Grissom CK, Auerbach PS, Rodway GW, et al. Wilderness Medical Society Practice Guidelines for the Prevention and Treatment of Frostbite. Wilderness Environ Med 2011;22:156-166.

  6. Roche-Nagle G, Murphy D, Collins A, Sheehan S. Frostbite: management options. Eur J Emerg Med 2008;15:173-175.

  7. Foray J. Mountain frostbite. Current trends in prognosis and treatment (from results concerning 1.261 cases). Int J Sports Med 1992;13:S193-196.

  8. Imray C, Grieve A, Dhillon S. Cold damage to the extremities: frostbite and non-freezing cold injuries. Postgrad Med J 2009;85:481- 488.

  9. Jurkovich GJ. Environmental cold-induced injury. Surg Clin North Am 2007;87:247-267.

  10. McCauley RL, Smith DJ, Robson MC, Heggers JP. Frostbite and other cold-induced injuries. In: Auerbach PS, ed. Wilderness medicine. 3rd ed. Mosby, 1995;129-145.

  11. Britt LD, Dascombe WH, Rodriguez A. New horizons in management of hypothermia and frostbite injury. Surg Clin North Am 1991;71:345-370.

  12. Zabadovskaia VD, Borodulin VG. Gamma-scintigraphy in deep frost-bites. Med Radiol 1981;26:8-10.

  13. Ikawa G, Dos Santos PA, Yamaguchi KT, Stroh-Recor C, Ibello R. Frostbite and bone scanning: the use of 99m-labeled phosphates in demarcating the line of viability in frostbite victims. Orthopedics 1986;9:1257-1261.

  14. Mehta RC, Wilson MA. Frostbite injury: prediction of tissue viability with triple-phase bone scanning. Radiology 1989;170:511-514.

  15. Kenney A III, Vyas P. Frostbite injury: Appearance on Three-Phase Bone Scan. Clin Nucl Med 1998;23:188.

  16. Cauchy E, Marsigny B, Allamel G, Verhellen R, Chetaille E. The value of technetium 99 scintigraphy in the prognosis of amputation in severe frostbite injuries of extremities: A retrospective study of 92 severe frostbite injuries. J Hand Surg Am 2000;25:969-978.

  17. Banzo J, Martínez-Villén G, Abós MD, Morandeira JR, Prats E, García-López F, y col. Congelaciones de manos y pies en un montañero de elite: utilidad de la gammagrafía ósea para predecir el nivel de amputación. Rev Esp Med Nuclear 2002;21:366-369.






>Journals >Cirugía y Cirujanos >Year 2013, Issue 4
 

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