AbstractsBiology & Animal Science

Cold intolerance: From thermoregulation to nerve innervation

by E.S. Smits

Institution: Erasmus University
Year: 2014
Keywords: cold intolerance; trauma of the hand; hand injuries; central disinhibition mechanism
Record ID: 1262193
Full text PDF: http://hdl.handle.net/1765/50518


abstract__Abstract__ Trauma to the hand is frequently seen in people working with machinery, during occasional handyman work in and around the house. In the Netherlands (a population of 16.7 million) 50.000 fractures of hand and fingers, 790 amputations of fingers and 200 nerve injuries are to be count every year. The largest population of hand and wrist injuries comprises of working class male between 20- 64 years of age, like Bram Beukers. The absolute number of patients with complex soft tissue injuries such as a traumatic amputation or a nerve injury is relatively low, but at the level of the individual patient, these injuries cause high health-care costs and a major loss of production. In 2007, hand and wrist injuries in the Netherlands annually account for 740 million U.S. dollar and rank first as most expensive injury types. In comparison, hip fractures cost 532 million U.S. dollar. Of the 740 million U.S. dollar costs of hand and wrist injuries, 11 million dollar (56%) is related to productivity costs. Per case these productivity costs have an average of 1580 U.S. dollar. One of the most bothersome long-term effects of a nerve injury is cold intolerance. Cold intolerance is an abnormal sensitivity to a cold environment or cold temperatures, and is defined as abnormal pain after exposure to mild or severe cold, with or without symptoms such as discoloration, numbness, weakness, or stiffness of the hand and fingers. It has been reported that cold intolerance seriously influences a patients daily life by being the most bothersome, prolonged and disabling symptom, affecting both work and leisure activities. Most likely, the cold intolerance develops within the first months after injury and the symptoms of cold intolerance often do not diminish over time. However, as in the story of Bram Beukers, it can have a later onset as well. Development of cold intolerance is seen in patients after ulnar (56%) or median (70%) nerve injury, a traumatic amputation 51%, a flexor tendon injury (66%),16 radial for arm harvesting (31%). At the start of this research project, the prevalence of cold intolerance in patients with fractures to the hand was still unknown.markdown