Self-reported symptoms of cold intolerance in workers with injuries of the hand.
Cold intolerance is a well-recognized complication of crushing injuries and amputations in the hand. These symptoms are usually thought to resolve within 2 years of injury. The objectives of our study were to determine the prevalence and course over time of self-reported symptoms of cold intolerance in workers with hand injuries. Files from a large worker's compensation carrier were randomly selected from index years 2, 4, 6, and 10 after a claim was made. Cohorts comprising cases with diagnostic codes corresponding to traumatic hand injuries and codes referring to non-trauma diagnoses in the hand were assembled for each of the years under consideration. A questionnaire was mailed to a total of 7,088 asking questions related to the symptom of cold intolerance. Twenty-five percent of the surveys were returned. Over 90% of trauma patients from all 4 years reported symptoms of cold intolerance. The rate of cold intolerance in the non-trauma group was between 59% and 69%. Individuals reporting cold intolerance indicated worsening over time in 50% of cases and improvement in only 9%. The severity of injury did not appear to be a factor in the development of cold intolerance. Symptoms of cold intolerance are highly prevalent in workers with significant hand injuries. Workers with non-trauma hand conditions also report a substantial prevalence of this symptom. The development of cold intolerance is not related to injury severity. The symptoms remain either static or deteriorate slightly over time. Improvement is experienced by less than 10% of patients.
Graham
Brent
B
Department of Surgery, University of Toronto, University Health Network, Toronto, ON, Canada. brent.graham@utoronto.ca
Schofield
Michel
M
J Hand Surg Br. 2001 Apr;26(2):151-4
11281669
J Hand Surg Am. 2001 Nov;26(6):1138-45
11721266
Microsurgery. 1996;17(5):264-7
9220441
J Occup Environ Med. 2004 May;46(5):473-8
15167396
J Hand Surg Am. 1998 Jul;23(4):635-46
9708377
Acta Chir Belg. 1992 Jul-Aug;92(4):204-8
1414139
Microsurgery. 1990;11(3):236-42
2215195
Ann Plast Surg. 1998 Mar;40(3):256-9
9523608
J Hand Surg Am. 1999 Jan;24(1):8-15
10048510
J Hand Surg Am. 1982 Mar;7(2):161-6
7069170
Plast Reconstr Surg. 1999 Jan;103(1):132-7
9915173
J Reconstr Microsurg. 1991 Jul;7(3):175-8
1890674
J Hand Surg Am. 1980 Jan;5(1):63-70
7365219
Plast Reconstr Surg. 1997 Jan;99(1):109-15
8982193
J Hand Surg Am. 1992 Nov;17(6):1139-45
1430956
J Hand Surg Br. 1997 Jun;22(3):308-16
9222907
Scand J Plast Reconstr Surg Hand Surg. 1995 Dec;29(4):343-8
8771262
J Hand Surg Br. 1987 Feb;12(1):78-81
3572187
Injury. 1987 May;18(3):203-5
3508851
J Hand Surg Am. 1978 Jul;3(4):313-9
681714
J Hand Surg Am. 1989 Jan;14(1):17-27
2723364
Br J Plast Surg. 1999 Jan;52(1):64-8
10343593
J Hand Surg Br. 1995 Apr;20(2):237-9
7797979
Injury. 1996 Nov;27(9):607-11
9039355
J South Orthop Assoc. 1998 Fall;7(3):192-7
9781895
J Hand Surg Am. 1991 Nov;16(6):1037-40
1748748