Frostbite: Frozen Fingers in an Otherwise Healthy Individual

BMJ Case Reports

A case of frostbite after excessive alcohol intake

A 24-year-old man presented to the emergency department with the complaint of swollen and discoloured fingers. The doctors inquired about his history and found that two nights prior to the presentation he had spent the night drinking excessively. The young man had then fallen asleep outside in the cold for approximately 3 hours. Moreover, the temperature that night had fallen to -7 degrees Celsius.

Examination and Investigations

On examination, the doctors found that the fingers were swollen due to oedema. They had a purplish-black discolouration, were insensitive to pain and did not bleed on pinprick. However, his toes were not affected. His baseline investigations including CBC and ECG were unremarkable. They made the diagnosis of frostbite.

Frostbite: Treatment

Since this condition requires conservative treatment only, the doctors treated his frostbite with simple dressings. Over the subsequent weeks, the wounds worsened before they got better. The little finger was the most affected during this time period.

Follow-up and prognosis

After a two-year follow-up, the patient’s injury had healed completely with no serious function deficits. However, his hands had become slightly intolerable to the cold, which the patient managed by wearing gloves in extreme weather.

Frostbite: what is it?

Frostbite is a cold injury that causes the epithelial tissue of the skin to freeze with intracellular crystal formation. Therefore, signs and symptoms start to appear which include hardened, pale and numb skin. If the doctors do not treat the frostbite quickly and efficiently, it may result in loss of skin tissue. Longstanding cases can cause ischemia and lead to necrosis.

Most doctors treat the frostbite by rewarming the digits in hot water, which they continue till the skin regains its colour and the tissue’s blood supply returns. It should be noted that rewarming should be done with caution, because it may lead to further injury if the procedure is done swiftly.


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