1328 - From frostbite to footsteps - a rare case of bilateral transtibial amputations secondary to frostbite

Thursday, February 19, 2026

5:00 PM - 6:30 PM AST

Presenting Author(s)

JB

Jessica Bailey, DO

Resident
University of Minnesota
Minneapolis, Minnesota, United States

Co-Author(s)

MM

Marlena Rose Mueller, DO

University of Minnesota Physical Medicine and Rehabilitation Faculty
University of Minnesota
Minneapolis, Minnesota, United States

Submitter(s)

JB

Jessica Bailey, DO

University of Minnesota
Minneapolis, Minnesota, United States

Case Diagnosis: 62-year-old male status post bilateral transtibial amputations secondary to frostbite of the bilateral lower extremities

Case Description: The patient presented to the ED via EMS after being found in his vehicle on a sub-zero degree night with frostbite. He was admitted to the burn surgery unit, where interarterial lytic therapy failed to improve wound healing. He was subsequently transferred to the VA with dry gangrene of both feet for planned bilateral transtibial amputations. His hospital course was complicated by sepsis and acute anemia requiring pRBC transfusions, leading to transfusion-associated circulatory overload and ICU transfer. He ultimately underwent right transtibial amputation after tissue demarcation was deemed complete. A left transtibial amputation took place 3 weeks later. Initial prognosis of prosthetic candidacy was guarded; the PM&R amputation service estimated a K1 ambulation level. With continued progress there was potential for reclassification as a K2 ambulator with prostheses and an assistive device. During PT evaluation he ambulated 15 minutes in parallel bars using a reciprocal pattern with good stability.

Discussions: Bilateral transtibial amputation secondary to frostbite is rare. Patients facing simultaneous bilateral amputations often face a difficult recovery. Other ailments and hospital complications occur frequently and often delay the healing and rehabilitation process. Patient motivation and perseverance in rehabilitation can impact functional outcomes despite an initially guarded prognosis.

Conclusions: Patients facing life altering amputations secondary to frostbite can achieve ambulation with intensive acute rehabilitation and multidisciplinary support.