Cold intolerance after flexor tendon injury. Disposing factors and long term prognosis

cold intolerance after hand injuries is often debilitating. We wished to determine what factors make it more likely to occur and whether it improves or worsens with time.

we retrospectively studied 103 patients who had sustained a simple cut leading to a flexor tendon injury in the finger between 3 months and 20 years earlier. A total of 48 had also injured a digital nerve. At review patients indicated on a VAS scale their dis-comfort during the first winter after injury and the last winter before review and also gave a VAS evaluation of pain in the hand after keeping it in a bath of water at 1-4 degrees centigrade for 60 seconds.

cold sensitivity during the first winter after injury was reported by 66% patients. Its development was unrelated to the age at injury. The proportions of smokers, injury of more than one finger, and re-operation or with postoperative complications were significantly higher among patients with cold sensitivity. At review 49% indicated that they had improved, 41% that cold sensitivity was unchanged and 10% that they were worse.

standardized immersion in cold water showed that on average cold sensitivity was slightly worse with time.