Abstract
Background
The purpose of this study was to evaluate the prevalence of cold sensitivity in patients with hand- and wrist-related diagnoses.
Methods
We included English-speaking adults who were more than 1 month following hand injury or onset of symptoms. Patients were asked if exposure to cold air or water provoked cold-related symptoms and to rank symptom severity (scale 0–10). Statistical analyses evaluated the relationships between the cold sensitivity and independent variables (age, gender, history of trauma, and time from injury/symptoms).
Results
There were 197 patients (mean age 49 ± 16 years): 98 trauma and 99 non-trauma cases. Cold-induced symptoms were reported by 34 %, with 10 % reporting severe symptoms. Exposure to cold air is the most common catalyst; mean severity score was 6.7 ± 2.2. Those with traumatic injuries compared to non-trauma diagnoses reported significantly more cold-induced symptoms (p = .04). Using backward linear regression, the significant predictors of cold symptom severity were trauma (p = .004) and time since onset (p = .003). Including only the trauma patients in the regression model, the significant predictor was time since injury (p = .005).
Conclusions
Cold-induced symptoms are reported by more than 30 % of hand-related diagnoses, and exposure to cold air was the most commonly reported trigger. The significant predictors of cold-induced symptoms are traumatic injuries and longer time from injury. This study provides evidence of the common problem of cold sensitivity in patients with hand pathology.
Level of Evidence: Prognostic Level II
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References
Campbell DA, Kay SP. What is cold intolerance? J Hand Surg. 1998;23B:3–5.
Carlsson I, Rosen B, Dahlin LB. Self-reported cold sensitivity in normal subjects and in patients with traumatic hand injuries or hand-arm vibration syndrome. BMC Musculoskel Disord. 2010;11:89–99.
Carlsson IK, Edberg AK, Wann-Hansson C. Hand-injured patients’ experiences of cold sensitivity and the consequences and adaptation for daily life: a qualitative study. J Hand Ther. 2010;23:53–62.
Collins ED, Novak CB, Mackinnon SE, Weisenborn SA. Long term follow-up of cold intolerance after nerve injury. J Hand Surg. 1996;21A:1078–85.
Craigen M, Kleinert JM, Crain GM, McCabe SJ. Patient and injury characteristics in the development of cold sensitivity of the hand: a prospective cohort study. J Hand Surg. 1999;24A:8–15.
Graham B, Schofield M. Self-reported symptoms of cold intolerance in workers with injuries of the hand. Hand. 2008;3:203–9.
Gustafsson M, Hagberg L, Holmefur M. Ten years follow-up of health and disability in people with acute traumatic hand injury: pain and cold sensitivity are long-standing problems. J Hand Surg. 2011;36E:590–8.
Harada N. Cold-stress tests involving finger skin temperature measurement for evaluation of vascular disorders in hand-arm vibration syndrome: review of the literature. Int Arch Occup Environ Health. 2013;75:14–9.
Henry FP, Farkhad RI, Butt FS, O’Shaughnessy M, O’Sullivan ST. A comparison between complete immobilisation and protected active mobilisation in sensory nerve recovery following isolated digital nerve injury. J Hand Surg. 2014;37E:422–6.
Irwin MS, Gilbert SEA, Terenghi G, Smith RW, Green CJ. Cold intolerance following peripheral nerve injury. Natural history and factors predicting severity of symptoms. J Hand Surg. 1997;22B:308–16.
Laskar MS, Harada N. Different conditions of cold water immersion test for diagnosing hand-arm vibration syndrome. Environ Health Prev Med. 2005;10:351–9.
Lied L, Lyderson S, Finsen V. Cold intolerance after flexor tendon injury. Disposing factors and long term prognosis. Scand J Surg. 2010;99:187–90.
Lithell M, Backman C, Nystrom A. Cold intolerance is not more common or disabling after digital replantation than after other treatment of compound digital injuries. Ann Plast Surg. 1998;40:256–9.
McMillan CR, Binhammer PA. Which outcome measure is the best? Evaluating responsiveness of the Disabilities of the Arm, Shoulder and Hand questionnaire, the Michigan Hand Questionnaire and the Patient-Specific Functional Scale following hand and wrist surgery. Hand. 2009;4:311–8.
Nancarrow JD, Rai SA, Sterne GD, Thomas AK. The natural history of cold intolerance of the hand. Injury. 1996;27:607–11.
Novak CB, Anastakis DJ, Beaton DE, Mackinnon SE, Katz J. Cold intolerance after brachial plexus nerve injury. Hand. 2012;7:66–71.
Novak CB, Anastakis DJ, Beaton DE, Mackinnon SE, Katz J. Validity of the Patient Specific Functional Scale in patients following upper extremity nerve injury. Hand. 2013;8:132–8.
Novak CB, McCabe SJ, Li Y, Fernie G. Cold sensitivity evaluation using cold air exposure versus cold water immersion. Kauai, Hawaii, American Society for Peripheral Nerve. Ref Type: Conference Proceeding 2014
Novak CB, Williams MM, Conaty K. Evaluation of the Patient Specific Functional Scale in hand fractures and dislocations. Hand. 2014. doi:10.1007/s11552-014-9658-2. in press.
Povlsen B, Nylander G, Nylander E. Cold-induced vasospasm after digital replantation does not improve with time. A 12-year prospective study. J Hand Surg. 1995;20B:237–9.
Povlsen B, Nylander G, Nylander E. Natural history of digital replantation: a 12-year prospective study. Microsurgery. 1995;16:138–40.
Ruijs ACJ, Jaquet J-B, Van Riel WG, Daanen HAM, Hovius SER. Cold intolerance following median and ulnar nerve injuries: prognosis and predictors. J Hand Surg. 2007;32E:434–9.
Sletten IN, Nordsletten L, Husby T, Odegaard RA, Hellund JC, Kvernmo HD. Isolated extra-articular neck and shaft fractures of the 4th and 5th metacarpals: a comparison of transverse and bouquet (intra-medullary) pinning in 67 patients. J Hand Surg. 2012;37E:387–95.
Smits ES, Nijhuis THJ, Huygen FJPM, Selles R, Hovius SE, Niehof SP. Rewarming patterns in hand fracture patients with and without cold intolerance. J Hand Surg. 2011;36A:670–6.
Stokvis A, Ruijs ACJ, van Neck JW, Coert JH. Cold intolerance in surgically treated neuroma patients: a prospective follow-up study. J Hand Surg. 2009;34A:1689–95.
Stratford P, Gill C, Westaway M, Binkley J. Assessing disability and change on individual patients: a report of a patient specific measure. Physiother Can. 1995;47:258–62.
Stratford P, Spadoni G. Assessing improvement in patients who report small limitations in functional status on condition-specific measures. Physiother Can. 2005;57:234–41.
Traynor R, MacDermid JC. Immersion in cold-water evaluation (ICE) and self-reported cold intolerance are reliable but unrelated measures. Hand. 2008;3:212–9.
Vaksvik T, Hetland K, Rokkum M, Holm I. Cold hypersensitivity 6 to 10 years after replantation of revascularisation of fingers: consequences for work and leisure activities. J Hand Surg. 2009;34E:12–7.
van den Berg WB, Vergeer RA, van der Sluis CK, ten Duis H-J, Werker PMN. Comparison of three types of treatment modalities on the outcome of fingertip injuries. J Trauma Acute Care Surg. 2012;72:1681–7.
Conflict of Interest
Christine B. Novak declares that she has no conflict of interest. Steven J. McCabe declares that he has no conflict of interest.
Statement of Human and Animal Rights
All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2008(5). This study was approved by our institutional Research Ethics Board.
Statement of Informed Consent
Informed consent was obtained from all patients for being in the study.
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Novak, C.B., McCabe, S.J. Prevalence of cold sensitivity in patients with hand pathology. HAND 10, 173–176 (2015). https://doi.org/10.1007/s11552-014-9694-y
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DOI: https://doi.org/10.1007/s11552-014-9694-y