The purpose of this study was to find a method of proving cold discomfort in patients who complain during the winter seasons, after receiving an internal fixation with a metal plate, and to determine the different in the developments of cold discomfort according to the type of metal plate used.

Among 26 cases of lateral malleolar fracture, 16 stainless-steel plates and 10 titanium plates were compared. Discomfort was induced by placing ice over both lateral malleoli (ice provocation test), and the side on which discomfort was induced first was recorded.

Ten patients who felt discomfort in the winter, among which 8 cases stainless-steel plate and 2 cases titanium plate. The degree of pain was rated as 3.6 on average (ranging 2-4) on the VAS (visual analogue scale).

Cold discomfort during the winter season can be confirmed by using the ice provocation test (p=0.0004). The frequency of discomfort during the winter season was higher (p=0.126) in cases filted with stainless-steel plate (50%) than in those with a titanium plate (20%).