title: [Amputation level after frostbite: role of bone scan. A case report].
abstract: 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.
  
  
  METHODS
  a 42 year old man suffered frostbite injury in the fingers and toes after more than 24 hours at 8,000 meters of altitude. The patient was treated with anticoagulant therapy and topical cures for six weeks. During this period, we performed two consecutive bone scan studies showing no changes in the level of vascularization. However, clinical improvement was important, devitalized tissues delimited to the level marked by the bone scan study, so amputation was performed.
  
  
  CONCLUSIONS
  Because the bone scan remained invariable, we believe that could help us to determine the amputation level early without delaying surgery.
authors: Departamento de Traumatología y Cirugía Ortopédica, Hospital Clínico Universitario Lozano Blesa. Zaragoza, Spain. lau_ezquerra@yahoo.es.
authors: Laura
authors: L
authors: Ezquerra-Herrando
authors: Departamento de Traumatología y Cirugía Ortopédica, Hospital Clínico Universitario Lozano Blesa. Zaragoza, Spain.
authors: Eduardo
authors: E
authors: Corella-Abenia
authors: Departamento de Traumatología y Cirugía Ortopédica, Hospital Clínico Universitario Lozano Blesa. Zaragoza, Spain.
authors: José María
authors: JM
authors: Zamora-Rodríguez
authors: Departamento de Traumatología y Cirugía Ortopédica, Hospital Clínico Universitario Lozano Blesa. Zaragoza, Spain.
authors: Jorge
authors: J
authors: Albareda-Albareda
authors: Departamento de Medicina Nuclear, Hospital Clínico Universitario Lozano Blesa. Zaragoza, Spain.
authors: Javier
authors: J
authors: Banzo-Marraco
mesh_terms: D000328:Adult; D000671:Amputation, Surgical / Q000379:methods*; D000925:Anticoagulants / Q000627:therapeutic use; D003131:Combined Modality Therapy; D003646:Debridement; D004431:Ear, External / Q000473:pathology; D050278:Finger Phalanges / Q000000981:diagnostic imaging*; D005385:Fingers / Q000098:blood supply / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D005627:Frostbite / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D006801:Humans; D007511:Ischemia / Q000517:prevention & control; D008297:Male; D009051:Mountaineering; D009336:Necrosis; D009666:Nose / Q000473:pathology; D011877:Radionuclide Imaging; D019275:Radiopharmaceuticals; D013669:Technetium Tc 99m Medronate; D050277:Toe Phalanges / Q000000981:diagnostic imaging*; D014034:Toes / Q000098:blood supply / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*
chemical_list: D000925:Anticoagulants; D019275:Radiopharmaceuticals; D013669:Technetium Tc 99m Medronate
keywords: amputation level; bone scan; congelación; frostbite; gammagrafía ósea; nivel de amputación