Residual Limbs of Amputees Are Significantly Cooler than Contralateral Intact Limbs

Abstract
To test the hypothesis that distal residual limbs (DRLs) have significant vasomotor abnormalities. Comparative surface temperature studies of DRLs using paired samples (DRL vs. similar site on intact contralateral limb). Thirty-six volunteer subjects with unilateral, upper or lower limb amputations were recruited and evaluated at a pain research center in an urban academic rehabilitation facility. Our main outcomes were subjects' residual limb temperature as measured by quantitative infrared telethermography (qIRT), temperature strips, and examiner's palpation, compared with the contralateral limb. The qIRT showed that the DRLs were significantly cooler than the corresponding area of the contralateral intact limbs (P < 0.01). The difference using temperature strips supported this finding (P < 0.05); while on physical examination, 39% of the residual limbs were perceived by the examiner as cooler than the corresponding unaffected limbs. DRLs as measured by qIRT were significantly cooler than the corresponding area of the contralateral intact limbs. A better understanding of these findings may be important in elucidating the pathophysiology of relevant clinical features such as a potential sympathetic component of postamputation pain.