1/40. frostbite: an orthopedic perspective.frostbite injury to the extremities has the potential for disastrous effects. This review provides information valuable to the orthopedic surgeon to aid in the evaluation and treatment of frostbite. The pathophysiology and predisposing factors that provide a basic understanding of the nature of frostbite are discussed. Accepted and experimental imaging studies and treatment options are also reviewed. An effort is made to give the orthopedic perspective on each issue, providing a valuable resource for all orthopedic surgeons involved in the care of the patient with frostbite.- - - - - - - - - - ranking = 1keywords = injury (Clic here for more details about this article) |
2/40. Upper aerodigestive tract frostbite complicating volatile substance abuse.Volatile substance abuse has become increasingly popular among today's youth. It has reportedly been used by up to 13% of teenage populations. physicians need to be aware of the potential complications which may arise from this form of substance abuse. We describe the case of a young male who presented with massive edema affecting his lips, oral cavity, oropharynx and trachea. It was later discovered that his injury was secondary to thermal trauma related to the abuse of a fluorinated hydrocarbon propellant. This presentation may easily be confused with allergic or angioneurotic edema. Denial by the patient can lead to a further delay in diagnosis. This case is especially notable since frostbite injury involving the upper aerodigestive tract is extremely rare. We discuss the differential diagnosis and the management principals required in the care of this patient. We also present a pertinent review of the literature related to both volatile substance abuse and its complications involving the airway.- - - - - - - - - - ranking = 2keywords = injury (Clic here for more details about this article) |
3/40. frostbite at the gym: a case report of an ice pack burn.The case is reported of a 59 year old woman who suffered a 1% total body surface area superficial partial thickness burn to her calf following the application of an ice pack. The cause, resulting injury, and subsequent management are discussed. It is possible that such injuries are common, but no similar reports were found in a literature search. awareness of the risk of this type of injury is important for all those entrusted with advising patients on the treatment of minor soft tissue injuries.- - - - - - - - - - ranking = 2keywords = injury (Clic here for more details about this article) |
4/40. Pinch reconstruction by hand to hand finger transfer associated with hallux transfer after a severe frostbite injury.We report a case of severe frostbite in which a pincer hand was created by microsurgical transfer of a partially amputated small finger from the opposite hand combined with microsurgical transfer of a partially amputated great toe which was subsequently lengthened.- - - - - - - - - - ranking = 4keywords = injury (Clic here for more details about this article) |
5/40. Oral frostbite injury from intentional abuse of a fluorinated hydrocarbon.BACKGROUND: A serious but rarely reported complication of halogenated hydrocarbon inhalation abuse is severe mucosal frostbite. CASE REPORT: A 16-year-old male attempted to "get high" by inhaling airbrush propellant which contained 1,1-difluoroethane (CAS #75-376). The patient lost consciousness and upon awakening his lips and tongue were frozen. He suffered first- and second-degree burns of the larynx with vocal cord involvement and first-degree burns of the trachea, main stem bronchi, and esophagus. The oral cavity had second- and third-degree burns which required debridement. CONCLUSION: This case demonstrates the unusual but severe damage that can occur with the abuse of fluorinated hydrocarbons.- - - - - - - - - - ranking = 4keywords = injury (Clic here for more details about this article) |
6/40. Liquid ammonia injury.The toxic effects of a gas depend on the time of exposure, concentration and its chemical nature. Pressurized liquids and gases exert an additional cold thermal injury and this may complicate the clinical picture. A patient who had an accidental exposure to liquid ammonia over a prolonged period, manifesting in cutaneous, respiratory and ocular damage in addition to a severe cold thermal injury (frostbite) with a fatal outcome is presented. The patient had flaccid quadriparesis and episodes of bradycardia, which has not been reported previously. These manifestations raise the possibility of the systemic toxicity in patients with prolonged exposure to ammonia.- - - - - - - - - - ranking = 6keywords = injury (Clic here for more details about this article) |
7/40. Frozen chips: an unusual cause of severe frostbite injury.A case of severe frostbite injury to the right foot is presented. This was caused by the inappropriate application of a bag of frozen chips to the foot in an attempt to ease non-specific pain. No specific acute traumatic injury was identified. As the patient was a teacher of physical education, the pain had initially been assumed to originate from a minor musculoskeletal injury. Full recovery ensued after surgical excision of necrotic tissue and split skin grafting. The danger of inappropriate overenthusiastic use of ice packs or other frozen material to treat soft tissue injuries is emphasised. The need for education to prevent similar future injuries is discussed.- - - - - - - - - - ranking = 7keywords = injury (Clic here for more details about this article) |
8/40. Salvage of avascular bone from frostbite with free tissue transfer.Traditional management of frostbite injury of the hands and fingers has been to allow demarcation to occur between viable and nonviable tissues, corresponding to the level of amputation required. In this case report, phalangeal length in mummified digits was maintained with free tissue transfer followed by evidence of bony revascularization on bone scan. Rather than waiting for tissue demarcation to occur, the authors propose that consideration be given to debridement of soft tissues in the frostbitten fingers followed by free tissue transfer to salvage length and function in the digital bony skeleton.- - - - - - - - - - ranking = 1keywords = injury (Clic here for more details about this article) |
9/40. Hyperbaric oxygen treatment in deep frostbite of both hands in a boy.An 11-year-old boy in good general health conditions suffered deep frostbite on six fingers while he was working without gloves as a beater during a hunt in poland at an outdoor temperature of -32 degrees C over a 4 h-period. Three days later he was first seen by a physician who planned to amputate the affected fingers. The patient was transferred by his family to our University Hospital in Aachen, germany. We found third degree frostbite on four fingers of the right and on two fingers of the left hand. Because of the late beginning of the therapy, the patient was treated by HBO(2) according to the Marx-schema for problem wounds (2,4 bar, total time at depth: 90 min, alternations of 100% O(2) and air breathing). HBO(2)-treatment was repeated daily for 14 days. No adverse events were recorded during the course of therapy. A total recovery of the severe frostbite was observed after 14 days of HBO(2)-treatment. Twenty-eight months after the injury the patient reports fully regained sensibility and no pain. The plain X-ray after this period showed no premature closure of the epiphyses or sclerosis of the metaphyses. Conclusions: Because of the low risk associated with HBO(2), and its potential therapeutic efficiency, HBO(2) should be recommended as adjunct therapy in the treatment of deep frostbite.- - - - - - - - - - ranking = 1keywords = injury (Clic here for more details about this article) |
10/40. Imaging of frostbite injury by technetium-99m-sestamibi scintigraphy: a case report.The appearance of superficial tissue is often an unreliable indicator of deep-tissue viability in cases of frostbite. We present a 34-year-old black man who was brought to the emergency department at fourth post-injury day with frostbite injury involving both lower extremities after prolonged exposure to subzero temperatures. In our previous experimental study, 99mTc sestamibi scintigraphy has been employed for evaluating frostbite injuries in rabbit hindlegs. In the case presented, 99mTc sestamibi scintigraphy, as a new diagnostic tool, was performed for detection of skeletal muscle perfusion on the fourth post-injury day. The scintigraphic images show diffusely reduced uptake in soft tissues of both calves and feet. It was thought that this hypoperfusion was due to viable but ischemic tissue. Five days after medical therapy, 99mTc sestamibi scan showed prominently increased uptake in both calves and feet and skin necrosis was observed. debridement of necrotic skin and subcutaneous tissue was performed, and split-thickness skin graft was applied for coverage of the skin defect. Healing was good 15 days after grafting. We think 99mTc sestamibi scan can be used for assessment of soft-tissue perfusion and evaluation of treatment in frostbite injury.- - - - - - - - - - ranking = 8keywords = injury (Clic here for more details about this article) |
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