Cold Hypersensitivity 6 To 10 Years after Replantation or Revascularisation of Fingers: Consequences for Work and Leisure Activities

Abstract

We investigated cold hypersensitivity and activity in 81 adults (male/female 76/5), 6 to 10 years after finger replantation/revascularisation (mean age at injury 43 (SD 15) years). Questionnaires included the McCabe Cold Sensitivity Severity Scale, Potential Work-Exposure Scale and the Disabilities of the Arm, Shoulder and Hand (DASH) score. Eighty per cent of the respondents were cold hypersensitive; 20% were severely or extremely cold hypersensitive. Of the 74 patients employed at injury, 7% had changed work and 4% were not working due to cold hypersensitivity. The median score for cold exposure at work at follow-up was 153 (scale 0-300). The correlation between cold sensitivity and DASH work was low. One-third of the respondents experienced limitations in their leisure activities because of cold complaints. Long-term cold sensitivity was mild or moderate for most patients. Many cold hypersensitive patients managed to continue to work even under cold conditions and cold hypersensitivity was a greater problem in leisure activities.

Prevalence of Cold Sensitivity in Patients with Hand Pathology

“…Cold sensitivity creates a large burden of illness, and it is poorly understood with no effective management [2,3,6,7,16,20,29]. As such, we suggest that cold sensitivity of the hand is underrepresented in the hand literature and that more concerted efforts should be made to understand and manage this problem.…”

Biomedical and Psychosocial Factors Associated with Disability After Peripheral Nerve Injury

“…Pain may also be associated with cold sensitivity 15,27,28,[64][65][66][67][68][69][70][71][72][73][74][75][76][77][78] . The present study showed that patients with peripheral nerve injury had high levels of cold sensitivity and disability and that disability was predicted by pain and cold sensitivity.…”

Neuropathic Pain in Patients with Upper-Extremity Nerve Injury

“…86,87,[89][90][91][92][93][94][95][96][97][98][99][100] Several studies have supported the continuation of cold-sensitivity symptoms in patients with hand injuries and nerve injuries and following replantation. 89,91,92,97,101,102 Campbell and Kay evaluated 176 patients following hand injuries, 73% of whom reported cold-related symptoms; most of these were related to pain. 91 Graham and Schofield evaluated patients more than 2 years after hand injury; 86 most of these patients (90% of trauma cases) reported cold intolerance, and only 9% reported an improvement over time.…”

“…36,[86][87][88][89] The terms ''cold sensitivity'' and ''cold intolerance'' have been used interchangeably in the literature; in this review, the term ''cold sensitivity'' is used, except in cases where reference is made to published studies whose authors have used the term ''cold intolerance.'' The symptoms of cold sensitivity are often attributed to poor outcome following traumatic peripheral nerve injuries and have been reported more frequently in patients with digital amputations and replantations.…”