COLD-INDUCED VASOSPASM AFTER FINGER REPLANTATION - ABNORMAL SENSORY REGENERATION AND SENSITIZATION OF COLD NOCICEPTORS

Cold-induced vasospasm which may present clinically as ''white fingers '', after hand injuries has been reported to be as high as 100% after replanted digital amputations. The exact cause of this is obscure and no specific treatment is available. To try to shed light on the cause of post-traumatic cold-induced vasospasm we evaluated replanted digits in seven patients who had had replantations more than 10 years ago. O ur results show that cold-induced vasospasm occurred in six out of sev en patients. Cold nociceptors were sensitised in patients who had abno rmal two point discrimination, all of whom responded to cooling by vas ospasm. One patient with normal circulation did not recover cold nocic eption during cooling. This indicates that secondary Raynaud's syndrom e after injuries to the hand may be related to sensitisation of cold n ociceptors. Even simple nerve injuries may lead to secondary Raynaud's syndrome.