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 techneti um 99m bone scanning performed in 92 patients who presented to Chamonix Hos pital with severe frostbite of the extremities in the past 12 years. The re sults of this study show that an initial bone scan las 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 pha langes and the eventual level of amputation (positive predictive value, 0.8 4). A second scan on approximately day 7 was even more sensitive and inform ative. A strong correlation existed between positive uptake and Eventual he aling (negative predictive value, 0.99). This study showed that Tc-99m bone scanning in the first few days after frostbite injury indicates the level of amputation in severe frostbite in more than 84% of cases. We propose an algorithm based on the results of this study that can be used to evaluate n ew medical and surgical management of frostbite injury. (J Hand Surg 2000;2 5A:969-978. Copyright (C) 2000 by the American Society for Surgery of the H and.).