• The status of hands and feet four years after injury by exposure to severe cold was studied in 100 soldiers evacuated from Korea in 1950 and 1951. Especially complete data, including a history, statement of symptoms, photographs of healed lesions, roentgenograms, circulatory measurements, and other physical findings were obtained from 89 patients. Subjective complaints and functional disturbances were more severe in winter than in summer and were generally more severe than would be expected from the physical appearance. The most frequent symptoms were excessive sweating, pain, cold feet, numbness, abnormal color, and abnormalities about the joints of the affected part. Cold injuries so severe as to cause limited areas of full-thickness necrosis of the skin were classed as of the third degree; the residua were generally scars with a punched-out appearance and characteristic deformities of the toenail. Fourth-degree frostbite, involving actual loss of tissue, produced much scarring, mutilation of terminal phalanges, and characteristic changes in the roentgenograms.
Blair JR, Schatzki R, Orr KD. SEQUELAE TO COLD INJURY IN ONE HUNDRED PATIENTSFOLLOW-UP STUDY FOUR YEARS AFTER OCCURRENCE OF COLD INJURY. JAMA. 1957;163(14):1203–1208. doi:10.1001/jama.1957.02970490001001
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