Frostbite

A high index of suspicion for compartment syndrome should be maintained and the affected extremity examined regularly.

Weekly follow-up is then required until wounds are stable. Consultation with an orthotist, podiatrist, or rehabilitation physician is necessary in the case of tissue loss and amputation.

Technetium-99m pertechnetate scintigraphy provides an index of the perfusion of the affected extremity. It provides a sensitive and specific assessment of the extent of deep tissue and bone injury. Some studies have found good correlation between scintigraphy findings at 48 hours and both intra-operative findings and ultimate prognosis.[2]Chaucy E, Chetaille E, Marchand V, et al. Retrospective study of 70 cases of severe frostbite lesions: a proposed new classification scheme. Wilderness Environ Med. 2001 Winter;12(4):248-55. http://www.wemjournal.org/article/S1080-6032(01)70753-3/fulltext http://www.ncbi.nlm.nih.gov/pubmed/11769921?tool=bestpractice.com [3]Bhatnagar A, Sarker BB, Sawroop K, et al. Diagnosis, characterization and evaluation of treatment response of frostbite using pertechnetate scintigraphy: a prospective study. Eur J Nucl Med Mol Imaging. 2002 Feb;29(2):170-5. http://www.ncbi.nlm.nih.gov/pubmed/11926378?tool=bestpractice.com It can also be used to assess the response to therapy.