Frostbite, Injury, and Trauma in the Extremities

Abstract

Purpose of Review

The objective of the study is to review the current methods of evaluating and managing both frostbite injury and non-thermal extremity vascular trauma, with an emphasis on endovascular techniques.

Recent Findings

The traditional management of frostbite has a well-established role for the rapid rewarming of injured tissues. This literature review highlights the evolution of the various management techniques with a specific focus on the more recent role of intra-vascular catheter-directed thrombolytic therapy. Non-thermal extremity trauma with resulting vascular injury requires prompt diagnosis that relies heavily on both the physical examination and the appropriate imaging.

Summary

Frostbite injury manifests as a progressive insult with distinct pathophysiologic phases during which imaging can guide appropriate care. Traditional medical management, in combination with intra-vascular catheter-directed thrombolytic regimens, can restore blood flow to poorly or non-perfused digits, thereby ultimately reducing the risk of delayed amputation. Non-thermal trauma to the extremities can result in a variety of vascular injuries. Interventional radiology plays a key role in diagnosis and an expanding role using transcatheter therapies in order to provide efficacious and optimal management of patients with vascular injury.

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