Fasciotomy after severe frostbites!
This is the arm of an elderly, demented gentleman who unfortunately wandered out of the confines of his own home. He was away from his family, in the cold, for a few days before he was found. He presented to the trauma bay in a comatose state, with diffuse frostbite injuries. They attempted a fasciotomy on the left arm in an attempt to save the extremity. However, due to the extent of the injury, the team's attempts at saving the limb were all for nought. As we can see in the picture, the muscle bellies of the flexor muscles are dark in colour (normally a nice pink), which is indicative of necrosis due to the length of exposure to the cold.
Frostbite injuries are caused by exposing a part of the body to cold temperatures, and freezing the skin/underlying tissue. This freezing causes vasoconstriction and death of the vessels, causing excess fluid to be improperly drained from the compartments. This, in turn, causes the muscles to swell, die, and break off into the bloodstream, causing multi-organ failure.