'Avocado hand' injuries spark health warning by plastic surgeon

The middle-class love affair with the avocado is costing us dear with doctors reporting a big increase in injuries related to preparation of the millennials' staple brunch fruit. One of the north's top plastic surgeons tells health correspondent Seanín Graham about its perils.

A big increase in the number of 'avocado hand' injuries has led to some surgeons calling for cigarette-style health warnings to be stuck on the label
Seanín Graham

IT has been dubbed the most middle-class injury to ever hit A&E departments.

But a top plastic surgeon in Northern Ireland has warned a rise in the number of patients who have caused 'significant' damage to their hands while preparing an avocado needs to be taken seriously.

Alastair Brown, who is based at the Ulster hospital in Dundonald, said many of the injuries he has treated have the potential to cause long-term damage and can seriously impact on people's working lives and hobbies.

"Previously we used to get similar injuries when people were using knives to separate frozen burgers - now it's avocados," he said.

"There's been at least four injuries over the past few months, these are all avoidable injuries by basically not stoning the fruit in the way they should be."

'Avocado hand' has now become part of A&E vernacular, with the term used for stab injuries received while trying to remove the fruit's slippy stone.

Oscar-winning actress Meryl Streep is the most high-profile victim of avocados while celebrity chef Jamie Oliver has repeatedly warned of their dangers.

Rocketing numbers of patients have turned up to hospitals in London for emergency treatment over the past year with the fruit-related trauma - while the trend was reported in a Dublin hospital earlier this month after a woman presented with a knife impaled in her finger.

With the Ulster hospital receiving all the north's plastic surgery referrals, Mr Brown told the Irish News he had performed microsurgery earlier that day on a man who had cut through a nerve in his finger while stoning an avocado for breakfast.

The patient, who works in Information Technology, will have only a 20 per cent chance of full sensation returning to his finger. He will require follow-up 'hand therapy' and rehabilitation over coming months.

"One of the nerves was cut, which causes sensation to finger. In certain people and certain jobs this can cause a life-long problem with it affecting function, it can also cause pain and discomfort," added Mr Brown.

"If they cut a tendon, it can also be quite severe depending on their jobs, their hobbies and day-to-day lives.

"Trying to stone an avocado with a sharp knife when the knife suddenly gives and cuts into the important structures of the finger, it can be difficult to repair - there's no guarantee they will retrieve their function, and that can be quite significant."

Such was the level of concern among doctors about the prevalence of the injuries that the British Association of Plastic, Reconstructive and Aesthetic Surgeons (BAAPS) even suggested that a cigarette-style 'warning label' be stuck on the fruit.

But Mr Brown said the first step is to raise more awareness.

"I certainly think the public should be made well aware of the injuries this can pose - you often get hand injuries, these can affect tendons, nerves and bone...this is high-leved hand trauma surgery."


How to cut an avocado safely:

Doctors at Beaumont Hospital in Dublin treated a 32-year-old woman who presented to their A&E department with the knife still impaled through her finger and the avocado. The case was detailed in the Irish Medical Journal earlier this month.

They described 'avocado hand' as: 'Classically, the patients hold the avocado in their non-dominant hand while using a knife to cut/peel the fruit with their dominant hand. The mechanism of injury is usually a stabbing injury to the non-dominant hand as the knife slips past the stone, through the soft avocado fruit. These stabbing injuries have the potential to cause significant neurovascular, tendinous and/or bony injuries.'

To cut an avocado safely, experts say:

- Place the fruit on a flat surface and with one hand on top holding the fruit firmly in place, gently make an incision around the stone with a sharp knife and then rotate the two halves apart.

- Then, wrap the half with the stone in it in a tea towel and taking the sharp knife, hack into the stone with the knife like an axe.

- Hold the avocado tightly and twist the knife in a turning motion and this should release the stone.

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