Emergency War Surgery NATO Handbook: Part I: Types of Wounds and Injuries: Chapter IV: Cold Injury
United States Department of Defense
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Although cold injury is seen only sporadically in the population in peacetime, it can be of paramount importance to an Army. Cold injury has played a major role in the outcome of a number of military operations throughout history. Larrey's description of the loss of over 250,000 soldiers of Napoleon's Army in Russia in 1812 identified cold as the major force in the defeat of this Grand Army. In the Crimean war (1852-1856), 309,000 French troops experienced 5,215 cases of frostbite, of which 1,178 were fatal. In just two nights, in Sevastopol, 2,800 cases of frostbite occurred, 900 of which were fatal. In World War I, the British incurred 115,000 trenchfoot or frostbite injuries. In one six-week period in one hospital in Rouen, there were 1,131 casualties with frostbite. In the Dardenelles, in the winter 1915-1916, there were 14,584 admissions for cold injury. U.S. Army cold injury losses in World War I amounted to 2,061 admissions, which translated to a total of 97,200 man days lost. In just two months in World War II, December 1941 and January 1942, the German army suffered 100,000 cold injuries requiring 15,000 amputations. That was a major factor in their defeat on the eastern front. U.S. experience in World War II and Korea reveals that fully 10 % of the wounded casualties (90,000 in World War II and 9,000 in Korea) were cold injuries. Recent British experience in the Falklands listed trenchfoot as the major medical problem in that conflict. Argentine amputations in the same conflict exceeded 200. Clearly, the impact that cold injury can have on military operations is a lesson that seems to have to be learned and relearned in each successive conflict.
Any force that is poorly fed, poorly clothed, or in retreat is more likely to sustain serious cold injury. Adding to the problems of command prevention of cold injuries, the medical personnel who provide care are often unaware of the seriousness of the threat and have little or no experience in dealing with these types of injuries.
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