COLD INTOLERANCE FOLLOWING PERIPHERAL-NERVE INJURY - NATURAL-HISTORY AND FACTORS PREDICTING SEVERITY OF SYMPTOMS

Cold intolerance can be severe and debilitating following injury to th e hand, Little is known about its natural history and factors predicti ng symptom severity. We looked retrospectively at upper limb periphera l nerve injuries over a 12-year period. Information was obtained using a patient questionnaire and patient records, The incidence of cold in tolerance was 83%, In 48% the onset of symptoms was within 1 month of the initial injury At a mean follow-up of 51 months improved symptoms were reported by 21%, while 18% deteriorated, Patients,were more likel y to develop cold intolerance if they smoked and less likely if they s uffered a sharp injury A score defining the severity of cold induced s ymptoms, based on the information collected, was calculated for each p atient, Significantly increased severity was associated with complete nerve division, median and ulnar nerve division and an associated vess el injury symptom improvement,vas significantly more likely in non-smo kers and a deterioration most likely with a high severity score.