title: Frostbite in an adolescent football player: a case report.
abstract: 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.
  
  
  METHODS
  Frostbite and constriction injury to the index finger.
  
  
  METHODS
  Emergency surgical decompression and occupational therapy.
  
  
  RESULTS
  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.
authors.affiliation: Department of Orthopaedic Surgery, Thomas Jefferson University Hospital, Philadelphia, PA.
authors.forename: Michael
authors.initials: M
authors.lastname: Rivlin
authors.forename: Marnie
authors.initials: M
authors.lastname: King
authors.forename: Richard
authors.initials: R
authors.lastname: Kruse
authors.forename: Asif M
authors.initials: AM
authors.lastname: Ilyas
mesh_terms: D000293:Adolescent; D003664:Decompression / Q000379:methods; D005383:Finger Injuries / Q000628:therapy*; D005538:Football / Q000293:injuries*; D005627:Frostbite / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D006801:Humans; D007036:Hypothermia, Induced / Q000009:adverse effects*; D008297:Male; D009788:Occupational Therapy / Q000379:methods