Differential Incidence of Cold Intolerance in Different Fingers After Performing Reverse Digital Artery Flaps for Finger Soft Tissue Defects

Objective: Cold intolerance is a common complication after the reverse digital artery flap procedure. However, we observed that the incidence of cold intolerance of different fingers was different. Therefore, we investigated the differences in the incidence of cold intolerance in different fingers and attempted to elucidate the causes of this phenomenon. Method: We recruited 37 patients and divided them into 3 groups based on injured finger, namely, 13, 13, and 11 patients for the index, middle, and ring finger groups in our study, respectively. Cold intolerance was subjectively reported by patients themselves. Our surgical procedure was designed in such a way that the reverse digital artery flap (RDAF) was located at the lateral area on the proximal phalange of the injured finger (on the ulnar side of the index, middle, and ring fingers) in consideration of patient aesthetics. Results: At final follow-up, 17 of 37 patients reported cold intolerance (index: 8; middle: 8; and ring: 1). Among the symptoms of discomfort, 9 patients mainly complained about the lower temperature of the flap upon exposure to cold weather compared with that of the uninjured area. Meanwhile, 3 patients complained of pain, and 5 patients reported numbness of the flap. The rate of cold intolerance in index, middle, and ring finger were 62%, 62%, and 9%, respectively. The patients’ age and sex did not significantly differ among the 3 groups. Significant differences were observed when we compared the incidence of cold intolerance of the index and ring fingers or the middle and ring fingers. Conclusion: Cold intolerance on the ring finger was obviously lower than intolerance in the index and middle fingers. Cold intolerance had a tendency to occur on fingers that sacrificed the dominant artery. And blood supply is an important predisposing factor for cold intolerance.