Avocado Alert! Hand Injuries on the Rise

Kitchen mishaps seem to be on the rise this time of year. In the summer months, hand surgeons often see more people with serious knife injuries from cutting fruits and vegetables. Over a recent two-week period, I performed hand surgery on three patients who sustained a knife injury while preparing an avocado. A slip of the hand led to tendon and nerve injuries in these individuals, and they’re not alone. A full 25 percent of surgical injuries seen in emergency rooms involve the hands.

Why the avocado? With its rock-hard pit and very soft fruit, cutting into it is an accident waiting to happen. The number one mistake people make is holding the avocado in their hand and cutting it toward their palm.

Our hands contain a dense collection of important tendons, nerves and vessels, so if your hand slips while plunging a sharp knife into an avocado, you’re likely to cut a critical structure. Tendon and nerve injuries are the most frequent and require urgent surgical repair.

A kitchen laceration that causes profuse bleeding or anything deeper than a skin wound warrants a trip to the emergency room, especially if you experience immediate numbness in one or more fingers or lose the ability to bend one of the finger joints.

The Right Way to Cut Fruits and Vegetables

Since avocado cutting injuries are the most common, it’s important to know the right way to prepare it. The best method is to place it on a cutting board with your open hand on top of it so you’re pressing down on it a bit. Then take the knife and cut into the side of the fruit, spinning it gently to make a 360-degree cut around the pit. Turn the avocado 90 degrees to and cut it again so you have quarters. It will then be easy to manually split the quarters off the pit. You can peel off the skin or scoop out the fruit.

Never try to remove an avocado pit by stabbing it with a knife. While experienced chefs may demonstrate this technique on TV, it is ill-advised for the rest of us. One of my patients who needed surgery was injured after she cut the avocado in half and then aimed a knife at the pit. The knife missed and she deeply cut her hand.

Another patient consulted me after injuring her hand while trying to separate frozen frankfurters with a knife. The knife went through the hot dogs and impaled her hand, which required microsurgical reconstruction and disabled two of her fingers for several months.

Another common kitchen injury involves potatoes. People believe that they need to poke holes in potatoes before baking them, and they often try to do so with a knife. Holding a potato, or any other food for that matter, in one’s hand while stabbing it with a sharp utensil can have serious consequences.

What to do if Injured

Don’t try to brush off a kitchen laceration. It’s important to have it evaluated in a timely manner. Tendon and nerve injuries are serious and time-sensitive. To avoid permanent damage, patients often require surgery by a hand specialist and weeks or months of specialized physical therapy.

If your hand or fingers are numb or don’t move normally after a kitchen knife injury, it’s important to be seen in the emergency room of a major hospital or in the office of a certified hand surgeon so that a specialist can promptly identify the gravity of the injury. It is advisable to avoid urgent care centers, as these facilities do not have the specialists available to properly evaluate the injury. A timely diagnosis is important because treatment within 72 hours generally leads to the best result. If more than two weeks go by, the repair may not be possible and the patient may experience permanent damage.

Specialized Hand Surgery at HSS

At HSS, we’ve refined our ability to repair serious hand injuries, conducting extensive research and developing new techniques. Microsurgery, which uses a microscope and very small instruments for complex nerve repair, should be performed by an experienced hand surgeon for the best result.

After surgery, it’s of the utmost importance to have rehabilitation by a specialized hand therapist. At HSS we work as a team with our certified hand therapists. Our patients meet with an experienced hand therapist before surgery so that they know what to expect and can practice their exercises in advance.  We’ve demonstrated that this greatly improves outcomes.

Advice to Avoid Kitchen Hand Injuries

Here are some basic tips to keep your hands safe while working in and around the kitchen:

  • Rarely hold a fruit or vegetable in your hand while cutting it. Use a cutting board whenever possible.
  • Place sharp utensils facing down in the dishwasher. Do not allow the sharp end of a knife to face up.
  • Be careful when reaching into a basin of soapy water. Do not leave knives in the basin.
  • Clean up any broken glass or ceramic immediately. Do not use your hands. Carefully sweep and vacuum as needed.
  • Wrap broken glass and sharp objects carefully with newspaper before disposing of them in a garbage bag. It’s also good idea to wrap metal can lids and any other items that have sharp edges.
  • Use care when disposing of a trash bag down a garbage chute – pushing it down with one’s hand can result in a deep laceration if there is broken glass or a sharp object inside.
  • Focus on what you’re doing and steer clear of distractions such as phone calls.
  • Be careful when taking pots and pans off the stovetop or removing food from the oven. Use oven mitts or pot holders to protect your hands. Replace worn out items.
  • Sharpen knives as needed. A dull knife is more likely to slip and cut you.
  • Store sharp objects in a safe location, especially if you have children in the home. Consider storing knives in a wood block instead of in a drawer.
  • When cooking pasta or another food in boiling water, use a colander to drain the water when you’re finished cooking. Do not use the lid to keep food in a pot while pouring out hot water. If the pot is too heavy for you to handle, ask for help.

Dr. Scott Wolfe is acknowledged to be one of the most experienced, innovative and authoritative experts in orthopedic upper extremity care. He is recognized for his expertise in the wrist and complex nerve injuries, fracture care, and for his leadership in improving the surgical education, skill level, and techniques practiced by the most up-to-date hand surgeons. 

The information provided in this blog by HSS and our affiliated physicians is for general informational and educational purposes, and should not be considered medical advice for any individual problem you may have. This information is not a substitute for the professional judgment of a qualified health care provider who is familiar with the unique facts about your condition and medical history. You should always consult your health care provider prior to starting any new treatment, or terminating or changing any ongoing treatment. Every post on this blog is the opinion of the author and may not reflect the official position of HSS. Please contact us if we can be helpful in answering any questions or to arrange for a visit or consult.