Amputation level after frostbite: role of Bone Scan. A case report

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.