Retrospective study of 70 cases of severe frostbite lesions: a proposed new classification scheme.

Objective: Previous frostbite classifications were mainly based on retrospective diagnosis and, most of the time, could not be used to predict the final outcome of the lesions and especially the probability of an amputation and its level. The aim of this study was to suggest a new classification at day 0 based mainly on the topography of the lesions and on early bone scan results, which are more convenient and accurate in predicting the final outcome of frostbites.

Methods: The retrospective study of the clinical histories of 70 patients hospitalized at Chamonix Hospital (Mont-Blanc Massif) from 1985 to 1999 for severe frostbite injuries of the extremities has allowed us to classify the aspects of the initial lesions on day 0 and to compare them with final outcomes.

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.

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.

The role of bone scanning in severe frostbite of the extremities: a retrospective study of 88 cases.

We performed a retrospective study of the results of two-phase technetium-99m hydroxymethylene diphosphonate bone scans in 88 patients with severe frostbite of the extremities. All patients were evaluated within 48 h after rewarming and all underwent a first bone scan (BS1) within 5 days after rewarming (median, day 2) (group 1). An excellent correlation was found between absence of tracer uptake in the phalanges and later amputation; this correlation was especially strong during the bone phase of the scans (specificity = 0.

Medical mountain rescue in the Mont-Blanc massif.

Because of its peculiar geographic location beneath Mont-Blanc, the Chamonix Hospital plays an important role in the management of mountaineering- and skiing-related traumatic injuries. The authors, thanks to the study of 5200 mountain rescue medical reports, set out to explain the different aspects of this activity: epidemiology, specific equipment, care in the field, reception and primary survey, dispatching, common therapeutic attitudes, progress, and results. In the dangerous environment of the high mountains, emphasis is put on the physicians' experience, allowing an early evacuation in the best conditions to the hospital.