Avocado related hand injuries are on the rise. Chefs and celebrities recently have been injured while attempting to cut the fruit, bringing increased attention to the risks involved. Most people accidentally cut their non-dominant hand which is holding the avocado. The knife can slip quickly through the soft flesh and into the hand which is holding the fruit. Nerve and tendon damage are common with this type of injury. This can result in several weeks or months of recovery after surgical repair of the lacerated structures.
In order to avoid a hand injury, cut the avocado only on a stable, flat surface. Do not cut towards your hand.
If you have a hand laceration, clean the wound in running water, place a clean bandage on the wound and hold pressure to stop bleeding. If the bleeding does not stop after 5-10 minutes of firm pressure on the wound, or if you have numbness in your hand or finger, or limited finger range of motion, seek medical attention promptly.
Metacarpal fractures are common hand injuries. They can occur from a variety of injuries such as a fall, a motor vehicle collision, or striking the fist against a hard surface. There are five metacarpals, one for each finger and the thumb. The metacarpals contribute to the bony architecture of the hand. Satisfactory healing of this fracture is important to restoring hand function. A fracture of the 5th metacarpal neck (the small finger) is sometimes called a “boxer’s fracture,” as they can be seen in punching injuries.
The treatment plan will depend on the severity of the fracture and the patient’s medical condition and activity level. Most people have fractures which are well-aligned, and, therefore, do not require surgery and are treated in a splint or cast. Follow-up x-rays are obtained to evaluate how the fracture is healing. Hand therapy is sometimes necessary to improve strength and range of motion of the hand.
Some patients with displaced fractures can be treated with manual realignment of the fracture. This is performed in the office or emergency room with local anesthesia such as lidocaine (numbing medicine). Once the bones are “set,” a splint is placed to maintain the alignment for a few weeks.
Surgery may be recommended to patients with more severe fractures, such as those fractures with poor alignment or when the bone breaks through the skin (open fracture).
WHAT IS INVOLVED WITH SURGERY?
The surgery is performed as an outpatient often using regional anesthesia or a nerve block. During surgery, the bones are realigned and stabilized. In some cases, a low-profile plate and screws are used to fix the bones internally. This is called “open reduction and internal fixation” and requires an incision on the back of the hand. In other cases, temporary pins are placed through the skin to stabilize the bones while they heal. This is called “closed reduction and percutaneous pinning.” The pins can be removed in clinic after a few weeks. Other options include intramedullary nail fixation and external fixation. Which technique is used depends on the fracture pattern and is often determined in the operating room. The bone healing process takes about 6 weeks, but full recovery for maximizing hand function can take a few months.
Call Raleigh Hand Center for a consultation on treatment of your metacarpal fracture
4th and 5th metacarpal fractures
Open reduction and internal fixation of 4th and 5th metacarpals
