["Teruel feet". Care and treatment of frostbite wounds in the hospitals of Navarra during the civil war]. / "Los pies de Teruel". Asistencia y tratamiento de las heridas por congelación en los hospitales navarros durante la guerra civil.

The care of combatants with lesions caused by frostbite during the battle of Teruel, which was fought in extreme weather conditions and in temperatures as low as twenty degrees below zero, was the period of greatest medical activity and the highest rates of occupation in the military hospitals of Navarre during the civil war of 1936-1939. From November 1937 to March 1938, 375 cases of frostbite were registered in the provincial establishments, amongst which there was a predominance of cases of dry gangrene partially affecting the lower extremity, which was popularly known as "Teruel feet". Some of the medical staff, conscious of the exceptional nature of the casuistry, registered statistics, clinical cases and personal impressions of the evolution of the lesions and the effectiveness of the treatments. In treating this affectation they employed medicines, surgical techniques and novel therapeutic procedures that were not widely used in the medical milieu of the time. However, the limited duration of the problem, the inconclusive results of the treatments and the differing opinions on their effectiveness -questions that are considered in this article- restricted the subsequent medical repercussion of the experiences of frostbite developed during the wartime period in Teruel.

'Los pies de Teruel'. Asistencia y tratamiento de las heridas por congelación en los hospitales navarros durante la guerra civil / 'Teruel feet'. Care and treatment of frostbite wounds in the hospitals of Navarra during the civil war

La atención a combatientes con lesiones por congelación sufridas durante la batalla de Teruel, desarrollada en condiciones meteorológicas extremas y temperaturas de hasta veinte grados bajo cero, supuso la etapa de mayor actividad asistencial y tasas de ocupación más altas en los hospitales militares navarros durante toda la contienda civil de 1936-1939. De noviembre de 1937 a marzo de 1938 se registraron en los establecimientos de la provincia más de 375 casos de congelación, entre los que predominaban las gangrenas secas con afectación parcial de la extremidad inferior, lo que popularmente se denominó 'pies de Teruel'. Algunos facultativos, conscientes de la excepcionalidad de la casuística, registraron estadísticas, casos clínicos e impresiones personales sobre la evolución de las lesiones y la efectividad de sus tratamientos. En ellos, emplearon fármacos, técnicas quirúrgicas y procedimientos terapéuticos novedosos en el tratamiento de esta afección y poco difundidos en el entorno médico del momento. Sin embargo, la limitación temporal del problema, los resultados poco concluyentes de los tratamientos y las opiniones controvertidas sobre su efectividad, cuestiones que se analizan en este artículo, limitaron la repercusión médica posterior de las experiencias sobre congelaciones desarrolladas durante la etapa bélica turolense

The care of combatants with lesions caused by frostbite during the battle of Teruel, which was fought in extreme weather conditions and in temperatures as low as twenty degrees below zero, was the period of greatest medical activity and the highest rates of occupation in the military hospitals of Navarre during the civil war of 1936-1939. From November 1937 to March 1938, 375 cases of frostbite were registered in the provincial establishments, amongst which there was a predominance of cases of dry gangrene partially affecting the lower extremity, which was popularly known as 'Teruel feet'. Some of the medical staff, conscious of the exceptional nature of the casuistry, registered statistics, clinical cases and personal impressions of the evolution of the lesions and the effectiveness of the treatments. In treating this affectation they employed medicines, surgical techniques and novel therapeutic procedures that were not widely used in the medical milieu of the time. However, the limited duration of the problem, the inconclusive results of the treatments and the differing opinions on their effectiveness –questions that are considered in this article– restricted the subsequent medical repercussion of the experiences of frostbite developed during the wartime period in Teruel

A case of bilateral trench foot.

A case of severe bilateral trench foot is presented in a patient who lived rough for 3 weeks without removing his boots. Non-operative management yielded no clinical improvement and bilateral below-knee amputation was necessary. Histology revealed subcutaneous and muscle necrosis with secondary arterial thrombosis.

Recent cases of trench foot.

Two cases of cold injury to the lower extremities, 'trench foot', are presented. The management is essentially conservative, but in cases of severe damage, particularly in elderly people, amputation must be advised.