Digital deformity: an effect of frostbite in children.

Two young children, aged 2 1/2 and 3 1/2, were briefly exposed to temperatures of -20 degrees F (-29 degrees C) without adequate hand protection. Hand contact with snow and metal doorknobs also occurred. Second and third degree frostbite of the cold injured digits ensured. 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.