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 intraoperative 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.