title: Cold-induced vasospasm after digital replantation does not improve with time. A 12-year prospective study.
abstract: The incidence of cold-induced vasospasm after hand injuries has been reported to be as high as 100%, following replanted digital amputations. The exact cause of this problem is obscure, no specific treatment is available and little is known about the long-term prognosis. Further knowledge is therefore needed in order to advise patients concerning future job potential at an early stage. In a previous paper we evaluated the incidence and severity of cold intolerance 2 years after digital replantation. The incidence of cold-induced vasospasm then was high as well as the discomfort experienced by the patients. We carried out a follow-up of patients previously examined 10 years ago. Our results show that cold induced vasospasm in replanted digits does not improve with time. Patients with moderate symptoms may perceive improvement, probably due to a change of habits. Patients with severe problems did not experience improvement and should be given early advice to seek work in warm surroundings to reduce the discomfort.
authors.affiliation: Department of Plastic Surgery, Hand Surgery and Burns, University Hospital of Linköping, Sweden.
authors.forename: B
authors.initials: B
authors.lastname: Povlsen
authors.forename: G
authors.initials: G
authors.lastname: Nylander
authors.forename: E
authors.initials: E
authors.lastname: Nylander
mesh_terms: D000673:Amputation, Traumatic / Q000601:surgery*; D001158:Arteries / Q000601:surgery; D001794:Blood Pressure / Q000502:physiology; D003080:Cold Temperature / Q000009:adverse effects*; D005383:Finger Injuries / Q000601:surgery*; D005385:Fingers / Q000098:blood supply*; D005500:Follow-Up Studies; D006801:Humans; D010991:Plethysmography; D011183:Postoperative Complications / Q000209:etiology*; D011446:Prospective Studies; D011928:Raynaud Disease / Q000209:etiology*; D012092:Replantation