Thermoregulatory control after upper extremity replantation.

Four patients with complete forearm amputations between the wrist and elbow were analyzed prospectively to determine the interrelationships of thermoregulation to pain, cold intolerance, arterial integrity, venous competence, motor nerve recovery, sensory nerve recovery, and time. Patients were examined at 6 weeks, 3 months, 6 months, 1 year, and 2 years after replantation. Vasomotor regulatory capacity was assessed by isolated cold-stress testing. Pain had diminished in all patients by 6 months to 1 year, regardless of other factors. Cold tolerance and normal thermoregulatory response, as indicated by cold-stress test performances, were temporally related to attainment of two-point sensory discrimination (p less than 0.05), or to motor nerve recovery (p less than 0.05), or to both.