Patient and injury characteristics in the development of cold sensitivity of the hand: a prospective cohort study.

In this prospective cohort study, we questioned whether cold sensitivity occurring after all types of injuries decreases, increases, or remains constant. We also questioned which patient and injury characteristics are most associated with the development of cold sensitivity. The degree of cold sensitivity of 123 patients with acute hand and forearm injuries was repeatedly scored from a prevalidated questionnaire over 11 months after injury. Twenty-five patients with more severe symptoms at 11 months were reassessed at 3 years. The patients' age, gender, smoking habit, workers' compensation status, mechanism of injury, level and orientation of injury, and injured structures were analyzed with respect to cold sensitivity. The results of our study indicate that the severity of cold sensitivity increased from the time of injury until 3 months following injury and then remained constant until 11 months following injury. At 3 years from injury, symptoms in patients with severe cold sensitivity had significantly reduced to 67% of the 11-month level. Cold sensitivity was common in all types of hand injuries, not just in amputations and in arterial or nerve injuries. A multiple linear regression analysis suggested that the severity of cold sensitivity was most related to the presence of bone injury. Cold severity was not specifically related to smoking or amputations.