Early Mobilization in Lower Extremity Frostbite Injury: Preliminary Experience at a Single Burn Center

Cold exposure that leads to frostbite puts patients at high risk for extremity amputations. Recent treatment advances, such as thrombolytic administration, have decreased amputation rates. However, little is known about patient outcomes with early mobilization of affected limbs. A retrospective review of 41 patients admitted for lower extremity frostbite was performed at an urban hospital burn unit. All patients received the institution's standard frostbite treatment protocol. The study group was allowed to bear weight within 72 hours, while the control group was immobilized beyond this time frame. No significant differences were found between groups when comparing total tissue loss, complications, or hospital length of stay. Previous treatment of frostbite at our institution involved strict avoidance of weight bearing to the affected extremity due to concern for repeat trauma and associated complications. Our findings show that patients who ambulated sooner had comparable outcomes to those immobilized for longer time periods. Larger studies would be useful to determine a standard time to mobilization in frostbite treatment protocols.