Prevention of Cold Injuries: What can be Learned from Nerve Injury Patients?

Patients who acquired an upper extremity nerve injury often complain about cold intolerance, reduced sensitivity and decreased task performance. This study tried to quantify these complaints and look in more detail at the thermal reaction to local cold exposure of the affected limb. We found that 36% of 107 subjects could be classified as cold intolerant. Eight of the cold intolerant subjects immersed their hands in 15°C water for 5 minutes after which infrared pictures of their affected hands were taken. The cold strain was acceptable for the patients. The damaged regions could easily be identified, most clearly 5 minutes after the hands were removed from the water. We conclude that the infrared temperature profile of the damaged hand after cold water immersion may be a helpful tool to assess the nerve damage. Similar tests exist for assessing the severity of non-freezing cold injuries (NFCI). We suggest that comparison of the results between NFCI and nerve injury patients may yield interesting information about the nervous involvement in NFCI. The method may also be valuable to identify subjects that have a higher risk for cold injuries. 1.0 INTRODUCTION Cold intolerance (= pain sensation in the hand on exposure to cold) is a frequent and invalidating finding both in nerve injury patients (Irwin et al., 1997; Lenoble et al., 1990) and in patients with non-freezing cold injuries (NFCI). The pathogenesis of cold intolerance is still essentially unclear. Cold intolerance is usually evaluated using the CISS (Cold Intolerance Severity Score) questionnaire in nerve injury patients (McCabe et al., 1991). In this study we aim to quantify the cold intolerance and sensitivity decrease in nerve injury patients and make a link to NFCI-patients. For NFCI-patients tests were developed to assess the cold injury severity (Francis and Oakley, 1996). We used a similar test for nerve injury patients to evaluate the outcome. 2.0 MATERIALS AND METHODS 2.1 Subjects A total of 107 upper extremity nerve injury patients participated in the study of which 88 patients performed the sensory recovery test. Eight subjects participated in a test using cold immersion of the hand. Jaquet, J.B.; Brandsma, M.; Daanen, H.A.M.; Hovius, S.E.R. (2005) Prevention of Cold Injuries: What can be Learned from Nerve Injury Patients? In Prevention of Cold Injuries (pp. 15-1 – 15-6). Meeting Proceedings RTO-MP-HFM-126, Paper 15. Neuilly-sur-Seine, France: RTO. Available from: http://www.rto.nato.int/abstracts.aps. Report Documentation Page Form Approved OMB No. 0704-0188 Public reporting burden for the collection of information is estimated to average 1 hour per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to Washington Headquarters Services, Directorate for Information Operations and Reports, 1215 Jefferson Davis Highway, Suite 1204, Arlington VA 22202-4302. Respondents should be aware that notwithstanding any other provision of law, no person shall be subject to a penalty for failing to comply with a collection of information if it does not display a currently valid OMB control number. 1. REPORT DATE 01 MAY 2005 2. REPORT TYPE N/A 3. DATES COVERED 4. TITLE AND SUBTITLE Prevention of Cold Injuries: What can be Learned from Nerve Injury Patients? 5a. CONTRACT NUMBER