Cut-off value for self-reported abnormal cold sensitivity and predictors for abnormality and severity in hand...

Area of Science:

• Orthopedics
• Hand Surgery
• Rehabilitation Medicine

Background:

• Cold sensitivity is a common, yet poorly defined, sequela following hand injuries.
• Objective quantification of cold sensitivity is needed for patient assessment and treatment evaluation.
• Existing measures lack established cut-off values for abnormality.

Purpose of the Study:

• To establish a reliable cut-off value for abnormal cold sensitivity using the Cold Intolerance Symptom Severity (CISS) questionnaire.
• To identify predictors of cold sensitivity and its severity after various hand injuries.

Main Methods:

• Investigated the CISS questionnaire and a visual analog scale (VAS) for cold discomfort.
• Evaluated 94 healthy individuals and 88 patients with hand injuries.
• Analyzed associations between injury characteristics (e.g., digit, vessel, nerve injury, replantation, bone injury, vascular grafts, Hand Injury Severity Score [HISS]) and cold sensitivity scores.

Main Results:

• A CISS score greater than 50 was defined as indicative of abnormal cold sensitivity.
• Multiple injured digits, increased injured vessels, complete nerve injury, and replantation were associated with higher VAS scores.
• Bone injury, more repaired vessels, vascular graft use, and a high HISS were linked to both abnormal cold sensitivity and worse symptom scores.

Conclusions:

• The study successfully established a CISS score cut-off (>50) for abnormal cold sensitivity post-hand injury.
• Cold sensitivity severity is multifactorial, involving bony, vascular, and neural elements.
• The identified cut-off value is valuable for descriptive, comparative, and assessment purposes in clinical practice and research.