Session Title: Virtual Poster Hall
Session Time: None. Available on demand.
Disclosures: James B. Meiling, DO: No financial relationships or conflicts of interest
Case Description: The patient presented with a left middle finger laceration after a knife slip while cutting an avocado. Examination of her left hand revealed a 3-cm long, 1-cm deep laceration curving from the base of the middle finger on the palmar aspect, laterally around and in between the index and middle finger, finally ending on the dorsal aspect of the hand. Good capillary refill was observed. She exhibited no focal weakness, and the tendons of the flexor digitorum superficialis, flexor digitorum profundus, and extensor digitorum communis muscles appeared to be intact. Sensory exam revealed numbness on the lateral aspect of her middle finger; 2-point discrimination was not intact, neither on the palmar nor dorsal aspects of the middle finger. These findings indicated palmar and dorsal digital nerve injuries to the radial aspect of the left middle finger, secondary to an accidental knife-inflicted laceration while cutting an avocado, colloquially known as “avocado hand.”
Setting: Community Hospital
Patient: 26-year-old female occupational therapist Assessment/
Results: She received a digital nerve block, 6 simple interrupted sutures, a splint to keep her fingers gently curved to encourage spontaneous healing, and a referral to a hand surgeon.
Discussion: With only 19 cases published in the literature, it would appear that the prevalence of this fruit-associated injury is rare. That being said, the National Electronic Injury Surveillance System estimates 50,413 avocado-related knife injuries from 1998 to 2017. “Avocado hand” appears to be under-published in the medical literature.
Conclusion: “Avocado hand” is an ever-growing, but under-published, hand injury, which can result in neurologic, tendinous, and vascular impairments. If digital nerve injuries occur, these need to be addressed quickly by a hand surgeon, to give the nerves the best possible chance of proper healing and recovery. This is especially important for individuals whose careers and hobbies depend on their ability to fully utilize their hands.
Level of Evidence: Level V
To cite this abstract in AMA style:Meiling JB, Sattar I. “Avocado Hand” and Knife-Associated Digital Nerve Injuries [abstract]. PM R. 2020; 12(S1)(suppl 1). https://pmrjabstracts.org/abstract/avocado-hand-and-knife-associated-digital-nerve-injuries/. Accessed November 29, 2022.
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PM&R Meeting Abstracts - https://pmrjabstracts.org/abstract/avocado-hand-and-knife-associated-digital-nerve-injuries/