Seasonal Variation in the Prevalence of Common Orthopaedic Upper Extremity Conditions

Abstract

Introduction Seasonal variation in disease processes and injuries have been reported, but it is unclear if this variation exists in upper extremity disorders. The goal of this study is to characterize seasonal and weather variations in common upper extremity orthopaedic conditions.

Methods This cross-sectional study reviewed 68,943 consecutive, new patient visits from January 2010 to September 2015 for carpal tunnel syndrome (CTS), trigger finger (TF), DeQuervain's tenosynovitis (DeQ), lateral epicondylitis (LE), hand arthritis (OA), and distal radius fractures (DRF). Presentation rates for each condition were compared across month, season, and various weather parameters.

Results DRF, OA, and LE had a higher rate of presentation in the winter compared with all other seasons (p < 0.001). TF and DeQ showed no statistically significant seasonal differences. Higher barometric pressures were associated with higher rates of all of the diagnoses. Higher humidity was associated with lower rates of CTS, TF, DeQ, LE, and DRF (p < 0.001). There was no significant association between temperature levels or amount of precipitation.

Discussion Although the precise mechanism remains unclear, there does appear to be an impact of winter, increased barometric pressure, and higher humidity on presentation rates. Further studies are needed to determine more conclusively why this occurs.

Level of Evidence Level IV, cross-sectional study.

Keywords

distal radius fracture - carpal tunnel syndrome - trigger finger - Dequervain's tenosynovitis - lateral epicondylitis - arthritis - seasonal variation

• References

• 1 Danai PA, Sinha S, Moss M, Haber MJ, Martin GS. Seasonal variation in the epidemiology of sepsis. Crit Care Med 2007; 35 (02) 410-415
• 2 Lanska DJ, Hoffmann RG. Seasonal variation in stroke mortality rates. Neurology 1999; 52 (05) 984-990
• 3 Peckova M, Fahrenbruch CE, Cobb LA, Hallstrom AP. Weekly and seasonal variation in the incidence of cardiac arrests. Am Heart J 1999; 137 (03) 512-515
• 4 Zangbar B, Rhee P, Pandit V. , et al. Seasonal variation in emergency general surgery. Ann Surg 2016; 263 (01) 76-81
• 5 Fares A. Global patterns of seasonal variation in gastrointestinal diseases. J Postgrad Med 2013; 59 (03) 203-207
• 6 Ricciardi R, Roberts PL, Read TE. , et al. Cyclical increase in diverticulitis during the summer months. Arch Surg 2011; 146 (03) 319-323
• 7 Wolkomir A, Kornak P, Elsakr M, McGovern P. Seasonal variation of acute appendicitis: a 56-year study. South Med J 1987; 80 (08) 958-960
• 8 Ilves I, Fagerström A, Herzig K-H, Juvonen P, Miettinen P, Paajanen H. Seasonal variations of acute appendicitis and nonspecific abdominal pain in Finland. World J Gastroenterol 2014; 20 (14) 4037-4042
• 9 Gamble DR, Taylor KW. Seasonal incidence of diabetes mellitus. BMJ 1969; 3 (5671): 631-633
• 10 Rising WR, O'Daniel JA, Roberts CS. Correlating weather and trauma admissions at a level I trauma center. J Trauma 2006; 60 (05) 1096-1100
• 11 National Centers for Environmental Information (NCEI). Available at: https://www.ncdc.noaa.gov . Accessed November 29, 2016
• 12 Past Weather in Philadelphia. Pennsylvania, USA. Available at: https://www.timeanddate.com/weather/usa/philadelphia/historic . Accessed November 29, 2016
• 13 Gamble DR, Taylor KW, Cumming H. Coxsackie viruses and diabetes mellitus. BMJ 1973; 4 (5887): 260-262
• 14 Dotta F, Censini S, van Halteren AGS. , et al. Coxsackie B4 virus infection of beta cells and natural killer cell insulitis in recent-onset type 1 diabetic patients. Proc Natl Acad Sci U S A 2007; 104 (12) 5115-5120
• 15 Alder AC, Fomby TB, Woodward WA, Haley RW, Sarosi G, Livingston EH. Association of viral infection and appendicitis. Arch Surg 2010; 145 (01) 63-71
• 16 Maguire LH, Song M, Strate LE, Giovannucci EL, Chan AT. Higher serum levels of vitamin D are associated with a reduced risk of diverticulitis. Clin Gastroenterol Hepatol 2013; 11 (12) 1631-1635
• 17 Scalco RS, Pietroski F, Celli LFS, Gomes I, Becker J. Seasonal variation in prevalence of carpal tunnel syndrome. Muscle Nerve 2013; 47 (06) 925-927
• 18 Saeed MA, Irshad M. Seasonal variation and demographical characteristics of carpal tunnel syndrome in a Pakistani population. J Coll Physicians Surg Pak 2010; 20 (12) 798-801
• 19 Jia J, Pollock M. The pathogenesis of non-freezing cold nerve injury. Observations in the rat. Brain 1997; 120 (Pt 4): 631-646
• 20 Rutkove SB. Effects of temperature on neuromuscular electrophysiology. Muscle Nerve 2001; 24 (07) 867-882
• 21 Kasselman LJ, Veves A, Gibbons CH, Rutkove SB. Cold exposure exacerbates the development of diabetic polyneuropathy in the rat. Exp Diabetes Res 2009; 2009: 827943
• 22 Chung MS, Gong HS, Baek GH. Prevalence of Raynaud's phenomenon in patients with idiopathic carpal tunnel syndrome. J Bone Joint Surg Br 1999; 81 (06) 1017-1019
• 23 Jacobsen SJ, Sargent DJ, Atkinson EJ, O'Fallon WM, Melton III LJ. Contribution of weather to the seasonality of distal forearm fractures: a population-based study in Rochester, Minnesota. Osteoporos Int 1999; 9 (03) 254-259
• 24 Jacobsen SJ, Sargent DJ, Atkinson EJ, O'Fallon WM, Melton III LJ. Population-based study of the contribution of weather to hip fracture seasonality. Am J Epidemiol 1995; 141 (01) 79-83
• 25 Øyen J, Rohde GE, Hochberg M, Johnsen V, Haugeberg G. Low-energy distal radius fractures in middle-aged and elderly women-seasonal variations, prevalence of osteoporosis, and associates with fractures. Osteoporos Int 2010; 21 (07) 1247-1255
• 26 Hoff M, Torvik IA, Schei B. Forearm fractures in Central Norway, 1999-2012: incidence, time trends, and seasonal variation. Arch Osteoporos 2016; 11 (01) 7
• 27 Wareham K, Johansen A, Stone MD, Saunders J, Jones S, Lyons RA. Seasonal variation in the incidence of wrist and forearm fractures, and its consequences. Injury 2003; 34 (03) 219-222
• 28 van Onselen EBH, Karim RB, Hage JJ, Ritt MJPF. Prevalence and distribution of hand fractures. J Hand Surg [Br] 2003; 28 (05) 491-495
• 29 Lofthus CM, Osnes EK, Falch JA. , et al. Epidemiology of hip fractures in Oslo, Norway. Bone 2001; 29 (05) 413-418
• 30 Pedrazzoni M, Alfano FS, Malvi C, Ostanello F, Passeri M. Seasonal variation in the incidence of hip fractures in Emilia-Romagna and Parma. Bone 1993; 14 (Suppl. 01) S57-S63
• 31 Shulman BS, Marcano AI, Davidovitch RI, Karia R, Egol KA. Nature's wrath---the effect of weather on pain following orthopaedic trauma. Injury 2016; 47 (08) 1841-1846
• 32 Funakubo M, Sato J, Obata K, Mizumura K. The rate and magnitude of atmospheric pressure change that aggravate pain-related behavior of nerve injured rats. Int J Biometeorol 2011; 55 (03) 319-326
• 33 Messlinger K, Funakubo M, Sato J, Mizumura K. Increases in neuronal activity in rat spinal trigeminal nucleus following changes in barometric pressure--relevance for weather-associated headaches?. Headache 2010; 50 (09) 1449-1463
• 34 Sato J, Aoyama M, Yamazaki M. , et al. Artificially produced meteorological changes aggravate pain in adjuvant-induced arthritic rats. Neurosci Lett 2004; 354 (01) 46-49
• 35 Patberg WR, Rasker JJ. Weather effects in rheumatoid arthritis: from controversy to consensus. A review. J Rheumatol 2004; 31 (07) 1327-1334
• 36 Strusberg I, Mendelberg RC, Serra HA, Strusberg AM. Influence of weather conditions on rheumatic pain. J Rheumatol 2002; 29 (02) 335-338