Frostbite complicating therapeutic surface cooling after heat stroke

Severe Frostbite Due to Extreme Altitude Climbing in South America: A Case Report

Frostbite is a tissue injury secondary to freezing that can currently be categorized using two schemes (Cauchy and clinical scheme). However, we present a fourth-degree frostbite case with overlapping features between both classifications, generating difficulty in categorizing it using either. We wanted to raise awareness of such an atypical presentation and propose employing both classifications to define the extent and compromise of frostbite more appropriately.

Frostbite in an adolescent football player: a case report

OBJECTIVE

To present the case of vascular compromise of a finger from a confluent circumferential blister due to an inappropriately applied commercial cold pack in a high school athlete and to describe the mechanism of iatrogenic injury, acute surgical management, rehabilitation, and pathophysiology of frostbite and constriction injuries.

BACKGROUND

A 17-year-old male football player presented with a frostbite and constriction injury to the index finger secondary to prolonged use of a cooling pack after a mild traumatic injury to the digit. He developed a prolonged sensory deficit from thermal injury, as well as acute vascular compromise requiring urgent operative intervention.

DIFFERENTIAL DIAGNOSIS

Frostbite and constriction injury to the index finger.

TREATMENT

Emergency surgical decompression and occupational therapy.

UNIQUENESS

Frostbite injuries can occur iatrogenically because of inappropriate use of cooling devices or gel packs. Fingers are commonly injured extremities that are particularly susceptible to frostbite and compression injuries. To our knowledge, no case of vascular compromise from the blister constriction of digits has been reported.

CONCLUSIONS

Patients and their caregivers must be educated about how to properly use cooling devices. Clinicians need to fully evaluate patients with iatrogenic frostbite injuries, giving particular attention to neurovascular status, and must recognize the need for surgical release of constriction syndrome to prevent substantial morbidity.