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Abstract
Background: The natural course and predictors for decreased cold hypersensitivity were studied in 85 patients with severe hand injuries involving nerve lesions.
Methods: Questionnaires including the McCabe Cold Sensitivity Severity scale (CSS 0–400) were collected after injury, and at 6-month, 12-month, 2-year, and 3-year follow-ups.
Results: Between the 12-month and 3-year follow-up, there was a small decrease in cold hypersensitivity as measured by the CSS (median = 24; Q1–Q3 = −11–75; n = 85). Five of the patients recovered from cold hypersensitivity, and ∼ 40% of the patients were less affected by cold hypersensitivity in daily life. Little or no pain early after injury and higher CSS-scores 12 months after primary surgery were weakly associated with the reduced CSS-scores (R2 = 0.20) at the 3-year follow-up. Six patients had changed work or did not work due to cold hypersensitivity, but the majority of the patients had kept their cold-exposed work.
Conclusion: Cold-hypersensitive patients may have a reasonable chance for decreased cold sensitivity and cold-associated activity limitations over time, although the majority of the patients will experience persistent problems. Tools to predict improvement remain insufficient.
Acknowledgements
We would like to thank the surgeons, hand therapists, and the administrative staff for facilitating the project logistics. The local Medical Ethical Committee South East, Norway, have approved the study (ref 2009/1821b). All the patients gave their written consent to participate in the study. he research was supported by a grant (8/2011) from Sophies Minde Ortopedi A/S.
Declaration of interest
The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.