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Patients will require a multidisciplinary team: Physicians Occupational therapists Specialist nurses Physiotherapist Prosthetist/ orthotist (if needed) Mental health (if needed) Return to Play/ Work Can take several weeks or months depending on the severity of the injury A player should not return to play the same day after thawing Complications and Prognosis Prognosis Generally drive by severity Frostnip: excellent Frostbite grade 2: good Frostbite grade 3: poor Frostbite grade 4: extremally poor Complications Functional Loss Cold sensitivity Taylor et al in patients with significant frostbite injury [34] 53% showed subsequent cold hypersensitivity 40% numbness of the digits 33% had reduced sensitivity to touch Chronic pain Common and troublesome for physicians Early involvement with pain management specialist is recommended Potential medications include Amitriptyline, Gabapentinoids Early introduction of neuropathic analgesics may reduce the risk of developing chronic pain [35] [36] Chronic ulceration Increased risk of chronic ulceration in patients with Areas of poor tissue quality Altered biomechanics and pressure areas Must be monitored for malignant transformation [37] Arthritis Arthritis following frostbite is well reported [38] Can also see Localized osteoporosis Subchondral bone loss Epiphyseal injuries in the skeletally immature See Also References Post PW, Donner DD

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