title: Mount Everest and Makalu cold injury amputation: 40 years on.
abstract: Freezing cold injuries (frostbite) of the extremities are a common injury among alpinists participating in high altitude expeditions, particularly during inclement weather conditions. Anecdotally, a digit that has suffered frostbite may be at greater risk to future cold injuries. In this case study, we profile a 62-year-old elite alpinist who suffered multiple digit amputations on both his hands and foot after historic summit attempts on Makalu (8481 m) and Mt. Everest (8848 m) in 1974-1979. We describe the clinical treatment he received at that time, and follow up his case 40 years after the first incidence of frostbite utilizing a noninvasive evaluation of hand and foot function to a cold stress test, including rates of re-warming to both injured and non-injured digits. Finger rates of recovery to the cold stress test were not different (0.8 vs. 1.0°C·min(-1)) except one (injured, left middle finger, distal phalanx; 0.4°C·min(-1)). Toe recovery rates after cold-water immersion were identical between previously injured and non-injured toes (0.2°C·min(-1)). Thermocouple data indicate that this alpinist's previous frostbite injuries may not have significantly altered his digit rates of re-warming during passive recovery compared to his non-injured digits.
authors.affiliation: 1 Environmental Physiology and Ergonomics Laboratory, Department of Automation, Biocybernetics, and Robotics, Jožef Stefan Institute , Ljubljana, Slovenia .
authors.forename: Shawnda A
authors.initials: SA
authors.lastname: Morrison
authors.forename: Jurij
authors.initials: J
authors.lastname: Gorjanc
authors.forename: Igor B
authors.initials: IB
authors.lastname: Mekjavic
mesh_terms: D000671:Amputation, Surgical; D001831:Body Temperature; D003080:Cold Temperature; D005385:Fingers / Q000503:physiopathology* / Q000601:surgery; D005500:Follow-Up Studies; D005627:Frostbite / Q000503:physiopathology* / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D009051:Mountaineering / Q000293:injuries*; D020127:Recovery of Function; D013312:Stress, Physiological / Q000502:physiology; D013817:Thermography; D014034:Toes / Q000503:physiopathology* / Q000601:surgery; D055815:Young Adult