title: The value of technetium 99 scintigraphy in the prognosis of amputation in severe frostbite injuries of the extremities: A retrospective study of 92 severe frostbite injuries.
abstract: We report a retrospective study of the prognostic value of 2-phase technetium 99m bone scanning performed in 92 patients who presented to Chamonix Hospital with severe frostbite of the extremities in the past 12 years. The results of this study show that an initial bone scan (as early as day 3) has excellent specificity in evaluating the severity of frostbite injury. There was a direct correlation between the demarcation zone of uptake in the phalanges and the eventual level of amputation (positive predictive value, 0.84). A second scan on approximately day 7 was even more sensitive and informative. A strong correlation existed between positive uptake and eventual healing (negative predictive value, 0.99). This study showed that (99m)Tc bone scanning in the first few days after frostbite injury indicates the level of amputation in severe frostbite in more than 84% of cases. We propose an algorithm based on the results of this study that can be used to evaluate new medical and surgical management of frostbite injury.
authors.affiliation: Department of Mountain Medicine and Trauma, Chamonix Hospital, Chamonix, France.
authors.forename: E
authors.initials: E
authors.lastname: Cauchy
authors.forename: B
authors.initials: B
authors.lastname: Marsigny
authors.forename: G
authors.initials: G
authors.lastname: Allamel
authors.forename: R
authors.initials: R
authors.lastname: Verhellen
authors.forename: E
authors.initials: E
authors.lastname: Chetaille
mesh_terms: D000328:Adult; D000671:Amputation, Surgical; D005260:Female; D005627:Frostbite / Q000000981:diagnostic imaging* / Q000601:surgery; D006230:Hand Injuries / Q000000981:diagnostic imaging* / Q000601:surgery; D006801:Humans; D008297:Male; D009336:Necrosis; D011379:Prognosis; D011877:Radionuclide Imaging; D013669:Technetium Tc 99m Medronate / Q000031:analogs & derivatives
chemical_list: C024226:technetium Tc 99m hydroxymethylene diphosphonate; D013669:Technetium Tc 99m Medronate