Avocado hand: How to avoid an injury so common that surgeons have a name for it

For avocado lovers, this is a dangerous time of year.

Thousands of people slice their hands and fingers every year while cutting avocados, and research shows that most of these injuries occur from April through July. Hand surgeons see these injuries so often that they have a name for it: Avocado hand.

The injury typically occurs when someone holds an avocado in one hand and wields a sharp knife in the other. When the knife slips, or the person loses their grip on the avocado as they’re cutting it, the knife can slice into their palm or fingers. It’s not uncommon for people to sever nerves and tendons. In some cases, people stab themselves in the hand while using the tip of a knife to remove the pit.

“I’ve treated people who’ve cut off a finger while slicing an avocado,” said Eric Wagner, a hand surgeon and associate professor of orthopedic surgery at Emory University in Atlanta. “Cutting an avocado seems so harmless, but we’ve seen some pretty bad injuries from it. By far and away the most injuries I’ve seen are from avocado injuries.”

Wagner and his colleagues encountered so many patients needing hand surgery because of avocado-related knife wounds that in 2020 they published a study that examined the phenomenon’s nationwide prevalence. They found that between 1998 and 2017, more than 50,000 people in the United States went to emergency rooms seeking treatment for avocado-related knife wounds.

Most striking was that the incidence of these injuries increased sharply over time. In the four-year period from 1998 to 2002, just 3,143 cases requiring emergency room visits were reported. But between 2013 and 2017, the rate shot up dramatically, with 27,059 emergency cases reported - a nearly ninefold increase. Wagner said that the rate of these injuries appears to be accelerating because he’s seen even more cases in the past five years than he saw previously.

The rising popularity of avocados

The jump in injuries closely mirrors the rising popularity of avocados. According to the federal government, the average American consumed about 1.5 pounds of avocados per year in 1989, but by 2017, the average intake had soared to about 7.5 pounds of avocados annually.

In a study published in the American Journal of Health Behavior, researchers found that about 2 percent of all consumer product-related injuries reported to the federal government stemmed from cutting avocados.

“That doesn’t seem like a lot, but it’s 1 in every 50 knife injuries,” said Matthew E. Rossheim, the lead author of the study and an associate professor in the School of Public Health at the University of North Texas Health Science Center in Fort Worth. “It’s shocking how many ER department visits are related to avocado hand cutting injuries.”

Avocado hand isn’t solely a U.S. phenomenon either. Studies have documented cases in a number of other countries, including England, Sweden, Switzerland and Ireland.

In the United States, Wagner and his colleagues found that most of the injuries occurred among women between the ages of 23 and 39, and that the wounds were usually on their left hand, likely because that was the hand they were using to hold the avocado while cutting into it. About half the people that were injured had suffered wounds to their palms. The other half had lacerations on their fingers, most often their index finger (34 percent of cases), followed by their thumb (19 percent of cases) or ring finger (17 percent of cases).

Most of the injuries took place on weekends from April through July. Wagner said he suspects this was because people are more frequently cooking, barbecuing and gathering outside for social occasions when the weather warms up, and that people may end up being a little less careful than usual.

“A lot of the people I see were at a family event when it happened and alcohol was involved,” he said.

How to safely cut open an avocado

Avocados are chock full of fiber, healthy fats, potassium, and other vitamins and minerals. They’re one of the most nutritious fruits you can eat (yes, they are technically fruits). But cutting them open shouldn’t mean risking a trip to the emergency room. So, here’s how to safely cut open an avocado:

- Place the avocado on a cutting board, using your non-dominant hand to hold it in place.

- With your dominant hand, hold a knife parallel to the cutting board and carefully cut the avocado in half lengthwise around the seed, rotating the fruit around the knife.

- Hold the avocado in your hands and make a twisting motion to separate the two halves.

- Hold the half that contains the pit in your non-dominant hand. Gently squeeze it to help separate the pit from the flesh and use a spoon to scoop it out with your other hand. Or try the “pop” method: Place both thumbs on the skin side, right behind the pit, and push the pit away from you.

- Place one half of the avocado skin-side down on the cutting board. Hold the side of the avocado with one hand, and cut from top to bottom, making sure the knife’s blade is perpendicular to the cutting board. Now repeat with the other half of the avocado.

- Use a spoon or your fingers to peel the skin from each quarter of the avocado. (If your avocado is ripe enough, you can go straight from pitting it to peeling off the skin with your fingers or a spoon.)

If you want to be especially safe, consider using a butter knife instead of a sharp knife. But most importantly, don’t cut your avocados while holding them in the palm of your hand, said Wagner, the hand surgeon at Emory.

“That makes no sense because if the knife slips then your thumb or index finger are going to get sliced,” he said.

Second, always remember to cut away from your hand or fingers so that they won’t be in the blade’s path if the knife or avocado slips.

Wagner said that he loves making homemade guacamole, but seeing so many injuries has made him extremely careful about how he slices avocados. “It definitely takes me a little longer to cut an avocado then it did back before I became a surgeon,” he said.

Wagner said that his wife, who is an orthopedic surgeon, has also changed her approach.

“I’ve told her so many horror stories about people cutting off their fingers that she’s super careful,” he added.