Between 1998 to 2002, there were just over 3,000 instances of an avocado hand injury. Recent data taken from 2020 found that from 2013 to 2017 avocado hand injuries increased by nearly 24,000.
Researchers speculated that people are eating more avocados than they were 20 years ago. In fact, most injuries involved the left hand or the likely non-dominant hand that people hold avocados in.
Interestingly enough, over 80% of cases were females and they were between the ages of 23 and 39 years old. However, an avocado hand injury can result in lasting damage if it is not properly taken care of.
If you have an interest in learning more about this hand injury, then keep reading on.
What Is Avocado Hand Injury?
An avocado hand injury occurs when someone is cutting and preparing an avocado. Typically, there are two ways that this injury happens.
First – once someone has cut the avocado in half, they try and remove the pit with the knife and it slips and cuts their hand. Second – once the pit is removed, the person cuts their fingers or hand through the avocado skin.
This results in a cut hand injury and can cause bleeding, torn tendons, and risk of infection. In very mild scenarios, you might be able to get away with rinsing, cleaning, and bandaging your hand.
However, most people use sharp knives when dealing with avocados which means there is a higher risk for more serious injury. Deeper lacerations require stitches and medical attention.
In some scenarios, the tendons and nerves are damaged, and you might need surgery.
Mild vs Severe Injury
How can you tell whether you have damaged the tendons, nerves, or muscles in your hand? You have two main functions of the tendons in your hands. The ones on the back of your hand help extend your fingers and wrist.
The tendons running along the palmar surface of your hand flex your fingers and wrist. There are other functions of tendons in your thumbs and wrist that help with fine motor movements.
In the majority of cases, people cut the flexor tendons as they are holding the avocado in their non-dominant hand. You can either cut your finger flexor tendons or the tendons running along the palm of your hand.
If you notice some of these signs, you have a more severe avocado hand injury and should seek medical attention:
- Significant bleeding
- Deep laceration
- Across a joint
- Decreased sensation
- Wound separation
Additionally, you may have treated your injury at home and then developed an infection. This is also a sign of a more serious injury and can cause lasting damage. Some common signs of infection are:
- Redness or swelling at the injury site
- Stiff neck
You should seek immediate medical attention for addressing your infection. Along with these negative health effects, infections can also cause further injury to your tendons, muscles, and nerves.
Avocado Hand Surgery
One study looked at patients who presented to the emergency department with a cut hand injury. These injuries occurred from cutting avocados and the patients had tendon or nerve injuries.
In most instances, the cases presented similarly to a single knife stab. Some cases involved multiple injuries. The three common surgeries people needed were:
- Repairing tendons
- Repairing nerves
- Pulley repair or reconstruction
Tendon repairs were the most common surgical intervention. It comprised over one-quarter of the surgical interventions.
So, what are some of the most effective surgical techniques for repairing tendons?
There are five main zones that surgeons look at with the hand. This does not include the regions of your thumbs. Typically, zone 1 starts at the most distal part of your fingers and then works its way down to your wrist.
Depending on where your injury is will determine what your surgeon does.
Zone 1 Techniques
This is a tough area for surgeons. It has higher complication rates and risk for immobility. Your surgeon might use multiple anchors for further stability. While they tend to cost more – they can reduce complications.
Additionally, the anchors are attached to your bones. People with osteoarthritis or poor bone density might not be good candidates
Zone 2 Techniques
A bit further down the fingers, you will encounter zone 2. Two strand repairs have been largely done away with. Your surgeon might opt for a four-strand repair instead. It has less likelihood of rupturing and leads to more positive outcomes.
Six-strand repairs are also becoming more popular. In some studies, it is showing a 96% success rate.
Zone 3 Techniques
Zone 3 is the main portion of your palm. Most of the surgeries in this zone have fairly good outcomes. There is a small risk of developing contractures in your finger tendons.
Contractures happen when tendons or tissues get stuck in a certain position. Scar tissue and adhesions can make it difficult for patients to fully extend their fingers. Rehabilitation is an important part of the rehab following a zone 3 repair to avoid this complication.
Zone 4 Techniques
Zone 4 is on the lower portion of your palm, right next to your wrist. Typically, this area is more protected than zone 3. This means it is unlikely that the injury is deep enough for tendon damage.
You are more likely to only need stitches in this area. However, if surgery is necessary, surgeons have found good success with a four-strand repair technique.
Zone 5 Technique
Zone 5 injuries are even less rare with avocado injuries since it involves more of the wrist. Many researchers suggest using the Kessler technique for surgical interventions. They found that this technique had better outcomes than other methods.
Sometimes, avocado injuries can affect the thumb on your non-dominant hand. Depending on where you are holding the avocado, your thumb might be in direct line of sight.
Four and six-strand repairs were advised for flexor tendon repairs. The exact spot of injury will dictate what your surgeon decides to do. Because the thumb is more mobile than your other fingers, a good hand therapist is critical to your overall recovery.
Wide Awake Surgery
Believe it or not – wide awake surgery has become a more popular technique. It is largely used for hand and wrist surgeries.
The benefit of wide-awake surgery is that patients are less at risk for anesthesia complications. They can also participate in some active movements that help surgeons during the repair process.
One study looked at the WALANT procedure. The WALANT procedure stands for ‘wide-awake local anesthesia with no tourniquet.’
The researchers found that when surgeons did not use a tourniquet, there was less risk of further nerve or blood vessel damage. If a patient is at risk for complications with general anesthesia, this is a great option.
It also lets surgeons perform the operation in an outpatient clinic versus a hospital setting. There were very few cases of infection compared to an inpatient setting.
This study found that the WALANT procedure was useful and effective for hand surgeries. In fact, almost 17% less of patients opted for opioid pain medications when using this technique.
It also costs less and the majority of patients stated they would choose this procedure again.
Hand Injury Rehabilitation
Physical therapy is a critical step in the recovery of your hand injury. A cut hand can cause lasting complications with fine and gross motor tasks such as gripping.
Rehabilitation can be implemented before or after surgery – depending on how severe the injury is. It typically follows the protocol for other hand injuries with similar mechanisms of injury.
These include injuries such as:
- Carpal Tunnel Syndrom (CTS)
- Torn wrist ligament
- Wrist/hand fracture
- Nerve damage
Physical therapists look at your mobility, pain, and function. Many other injuries present with similar symptoms and mobility issues. For instance, CTS patients often have complaints of decreased grip strength, numbness, or tingling.
An avocado hand injury can present in a much similar way. If you work with a physical therapist before surgery, the goal might be to reduce pain and manage your swelling.
If there is significant damage to the tendons, your therapist may not want to stress excessive stretching or strengthening. Instead, modalities and gentle movements are encouraged.
Following surgery, physical therapy will slowly ramp up in intensity. Most research is pointing towards active therapy within the first week of surgery. In recent studies, active movements early on have posted better results and outcomes.
Most surgeons recommend a hand or finger splint that helps immobilize the hand when you aren’t participating in therapy. You should also elevate the extremity when you can.
The splint should keep the wrist in a neutral position and the main flexor joint of your hand at 40 to 50 degrees of flexion. Around weeks four to six, it is likely the splint will transition to nighttime only.
The exercises might start with gentle active and passive movements. Active movements involve you doing the exercises. These can be things as simple as making a fist or touching the tips of your fingers together.
Passive movements involve stretching or the therapist moving your joints. Both activities are beneficial for helping improve mobility and range of motion. It also brings blood flow and nutrients to the area which helps improve the healing process.
Too much stretching or aggressive movements early on can damage the surgical site. This is why it is important that you follow the guidelines from your therapist and surgeon. Once you have progressed through the early stages, rehab can take anywhere from weeks to months.
Eventually, more intensive exercises involving grip, forearm, and finger strength will resume. Manual resistance or other tools are used for improving someone’s strength.
Many of the exercises used for avocado hand are similar to carpal tunnel. With any injury, you want to warm up your joints and muscles. You can start with simple stretches and easy, active movements.
Some common stretches and exercises that you can do on your own or with a therapist include:
- Wrist flexion and extension
- Nerve glides
- Tendon glides
- Grip squeezes
You can also practice simple activities at home such as grabbing cans, shaking your hands dry, or making a praying motion. These movements help stretch out your tendons and muscles.
They also work towards strengthening them. You can grab a small weight or can of soup and hang your wrist off the table. Slowly flex and extend your wrist with the can.
Try flipping your palm up and doing it that way too. You will likely see the tendons on the back and front of your forearm tightening. These tendons stretch all the way down to your fingers.
Other simple tools like a grip squeeze with a ball and playdough help strengthen your hand and fingers. Try separating playdough with your fingers spread out, or bring it back together. It may seem simple, but you will find that it can become challenging after multiple repetitions.
Additionally, nerve and tendon glides work at reducing scar tissue. It also decreases your risk of developing a contracture. Your therapist can walk you through different glides depending on what nerves or tendons were damaged.
If you have a job that requires a lot of fine motor movement you may find it helpful to see an occupational therapist. Certain physical therapists or occupational therapists specialize in hand therapy. An occupational therapist can also help you with return-to-work tasks such as typing on a keyboard.
Find Your Surgeon
Many people love avocados and they can be a great part of a healthy diet. Make sure you are taking extra precautions and avoiding placing your non-dominant hand where a knife could slip through.
Yet, if you have suffered from an avocado hand injury, then you could benefit from reaching out to a trusted and reliable hand clinic. Our hand surgery specialists can help you schedule an appointment and gain back your hand mobility and function.