Cauchy et al proposed a new classification of frostbite lesions involving the extremities. Findings after initial rewarming and on day 2 after admission may be helpful in management planning. The authors are from Chamonix, France.
Parameters:
(1) initial lesion on day 0 after rapid rewarming
(2) radiotracer uptake in bone scan on day 2
(3) skin blisters on day 2
Initial Lesion
Radiotracer Uptake on Bone Scan
Skin Blisters
Grade
none
not indicated
none
1
on distal phalanx
hypofixation of radiotracer
clear fluid
2
on middle phalanx, may involve proximal
absence of uptake on digits
hemorrhagic, on digit
3
carpal or tarsal
absence of uptake on carpal/tarsal
hemorrhagic, over carpal/tarsal
4
Grade
Outcome
1
no amputation and no long term sequelae
2
some tissue amputation with fingernail sequelae
3
bone amputation in digit; functional sequelae
4
more extensive amputation; may suffer thrombosis; may become septic; may have systemic illness; functional sequelae
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