PEDIATRICS Vol. 71 No. 6 June 1983, pp. 955-959
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Digital Deformity: An Effect of Frostbite in Children

Forst E. Brown MD1, Peter K. Spiegel MD1, and William E. Boyle Jr MD1

1 From the Sections of Plastic (Hand) Surgery, Radiology, and Pediatrics, Dartmouth Medical School, Hanover, New Hampshire

Two young children, aged 2frac12 and 3frac12, were briefly exposed to temperatures of -20°F (-29°C) without adequate hand protection. Hand contact with snow and metal doorknobs also occurred. Second and third degree frostbite of the cold injured digits ensued. Within six months, and progressing thereafter, the fingers developed a stubby appearance and demonstrated distal angulation and weak extension. Roentgenograms revealed undermineralization of the phalanges and coarsening of the trabecular pattern. The epiphyses of the middle and distal epiphyses were absent or atrophic. The metaphyses were irregularly convoluted. The pathogenesis of this deformity appears to be the direct effect of freezing and of ischemia on the most metabolically active site in the digit—the growth plate.

Key Words: digital deformity • frostbite • hand injury

Submitted on June 18, 1982
Accepted on August 23, 1982