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Cold Intolerance Following Median and Ulnar Nerve Injuries: Prognosis and Predictors

From the Department of Plastic, Reconstructive and Hand Surgery, Erasmus MC, Rotterdam, The Netherlands, the TNO Human Factors, Thermal Physiology Group, Soesterberg, The Netherlands and the Faculty of Human Movement Sciences, Vrije Universiteit, Amsterdam, The Netherlands

Correspondence: Ms Aleid CJ Ruijs, MD, Department of Plastic and Reconstructive Surgery, Erasmus MC, P.O. Box 2040, 3000 CA Rotterdam, The Netherlands. Tel.: +31 6 33041584/+31 10 4633407; fax: +31 10 4632693. E-mail:AleidRuijs{at}hotmail.com

This study describes the predictors for cold intolerance and the relationship to sensory recovery after median and ulnar nerve injuries. The study population consisted of 107 patients 2 to 10 years after median, ulnar or combined median and ulnar nerve injuries. Patients were asked to fill out the Cold Intolerance Severity Score (CISS) questionnaire and sensory recovery was measured using Semmes–Weinstein monofilaments. Fifty-six percent of the patients with a single nerve injury and 70% with a combined nerve injury suffered abnormal cold intolerance. Patients with no return of sensation had dramatically higher CISS-scores than patients with normal sensory recovery. Females had higher CISS scores post-injury than males. Cold intolerance did not diminish over the years. Patients with higher CISS scores needed more time to return to their work. Age, additional arterial injury, site or type of the injury and dominance of the hand were not found to have a significant influence on cold intolerance.

Key Words: peripheral nerve injury • median nerve • ulnar nerve • upper extremity injury • cold intolerance • cold sensitivity

Journal of Hand Surgery (European Volume), Vol. 32, No. 4, 434-439 (2007)
DOI: 10.1016/J.JHSB.2007.02.012


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