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Managing cold intolerance after hand injury: A systematic review
Bradley H C Greene1, Rakesh Gudimella1, Joseph P Corkum1
1Division of Plastic and Reconstructive Surgery, Dalhousie University, Halifax, Nova Scotia, Canada.
Hand Surgery & Rehabilitation
|January 31, 2023
Summary
Cold intolerance (CI) rarely improves over time for patients with hand injuries. Current management strategies like behavioral therapy show limited efficacy, and pharmacotherapy lacks evidence.
Area of Science:
- Orthopedics
- Hand Surgery
- Rehabilitation Medicine
Background:
- Cold intolerance (CI) is a common complication following hand injuries.
- Understanding the natural progression and effective management of CI is crucial for patient recovery.
Approach:
- A systematic review was conducted using multiple databases (MEDLINE, PubMed, Embase, CINAHL, Cochrane Library, Web of Science, Google Scholar).
- Included studies focused on the natural history of CI, behavioral therapies, and surgical interventions in adult patients with a history of hand injury.
- Seventeen studies were analyzed, primarily prognostic and prevalence studies, with limited high-level evidence.
Key Points:
- Cold intolerance (CI) generally does not resolve spontaneously over time in the majority of patients.
- Behavioral and self-management therapies demonstrate low efficacy for managing CI.
- Existing literature lacks studies on pharmacotherapy for CI, indicating a significant evidence gap.
Conclusions:
- Cold intolerance (CI) is often a persistent condition post-hand injury.
- Current non-pharmacological interventions for CI have limited effectiveness and are prone to bias.
- Future research should explore pharmacotherapeutic options for managing cold intolerance.
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