Small-to-moderate decreases in cold hypersensitivity up to 3 years after severe hand injuries: A prospective cohort study

J Plast Surg Hand Surg. 2016;50(2):74-9. doi: 10.3109/2000656X.2015.1089877. Epub 2015 Sep 28.


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 (R(2) = 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.

Keywords: McCabe Cold Sensitivity Severity scale CSS; activities of daily living; cold hypersensitivity; cold intolerance; cold sensitivity; hand injury; nerve injury.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Activities of Daily Living
  • Cohort Studies
  • Cryopyrin-Associated Periodic Syndromes / physiopathology*
  • Female
  • Follow-Up Studies
  • Hand Injuries / complications*
  • Humans
  • Male
  • Middle Aged
  • Prospective Studies
  • Time Factors

Supplementary concepts

  • Cold Hypersensitivity