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Pumpkin Carving Safety Tips

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Use caution during the Halloween season, and take steps to prevent hand injuries when carving.

“Every Halloween season we see four or five patients — both adults and children — who come into our office with severe injuries to their hands and fingers,” says Jeffrey Wint, MD, an ASSH member from The Hand Center of Western Massachusetts in Springfield, Mass. “Treatment can often run three to four months, from the time of surgery through rehabilitation.”

To prevent hand injuries, the American Society for Surgery of the Hand (ASSH) suggests the following safety tips:


Wash and thoroughly dry all of the tools that you will use, including: carving tools, knife, cutting surface, and your hands. Any moisture on your tools, hands, or table can cause slipping that can lead to injuries.


“All too often, we see adolescent patients with injuries because adults feel the kids are responsible enough to be left on their own,” says Wint. “Even though the carving may be going great, it only takes a second for an injury to occur.”


Never let children do the carving. Wint suggests letting kids draw a pattern on the pumpkin and having them be responsible for cleaning out the inside pulp and seeds. When the adults do start cutting, they should always cut away from themselves and cut in small, controlled strokes.


“A sharper knife is not necessarily better, because it often becomes wedged in the thicker part of the pumpkin, requiring force to remove it,” says Wint. “An injury can occur if your hand is in the wrong place when the knife finally dislodges from the thick skin of the pumpkin. Injuries are also sustained when the knife slips and comes out the other side of the pumpkin where your hand may be holding it steady.”


Special kits are available in stores and include small, serrated pumpkin saws that work better because they are less likely to get stuck in the thick pumpkin tissue. “If they do get jammed and then wedged free, they are not sharp enough to cause a deep, penetrating cut,” says Wint.


Should you cut your finger or hand, bleeding from minor cuts will often stop on its own by applying direct pressure to the wound with a clean cloth. If continuous pressure does not slow or stop the bleeding after 15 minutes, an emergency room visit may be required.

Copyright © American Society for Surgery of the Hand 2009.

Metacarpal fracture treatment in Raleigh NC

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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).


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

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Dr. Messer lectures on TFCC injuries

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Dr. Terry Messer presented at WakeMed UNC hand conference on Monday October 9, 2017 and discussed TFCC injuries of the wrist. Local hand surgeons, therapists, residents, and radiologists were present. 

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Dr. Erickson returns from national hand conference

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Dr. Erickson attended the annual Robert E. Carroll Hand Club meeting June 21-24, 2017. The meeting was held in Bolton Landing, NY. Attending orthopedic and plastic surgery hand specialists discussed current treatment options for their patients with hand and upper extremity conditions.  

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Dr. Messer presents at Regional Hand Conference

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Dr. Terry Messer of Raleigh Hand Center presented “Variations in clinical practice among hand surgeons in a private practice hand and upper extremity group” at the 40th Annual Southeastern Hand Society (SEHS) Meeting in Kiawah Island on April 27-30th. He served as Vice-President of the SEHS at the time of the meeting, and he is now the President-Elect.

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Dr. Erickson lectures at two conferences

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Dr. John Erickson provided a lecture on “Benign and Malignant Bone Tumors of the Hand and Wrist” at WakeMed UNC Orthopedic Hand Conference on 4/10/2017. Dr. Erickson also presented “Dupuytren’s Contracture Treatment” at Duke Raleigh Hospital Orthopedic Grand Rounds on 6/14/2017.

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Dr Edwards III discusses infection control at conference

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Dr. George Edwards III gave a lecture at the AORN regional meeting on 3/4/2017 in Chapel Hill. He discussed infection control in the operating room.

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Dr. Messer presents at Duke Hand and Upper Extremity Course

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Dr. Terry Messer of Raleigh Hand Center presented at the Duke Residents and Fellows Upper Extremity Course in March 2017. He discussed “Proximal Interphalangeal Joint Fracture Dislocations.”

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What is Carpal Tunnel Syndrome?

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Carpal tunnel syndrome is the most common nerve problem in the hand. It results from increased pressure on the median nerve at the wrist, within the carpal tunnel. Symptoms such as numbness, tingling, weakness, and hand pain can result if the nerve is compressed or “pinched.”

The word “carpus” means “wrist.” The carpal tunnel is a passageway in the wrist through which the median nerve and tendons of the hand travel. The carpal tunnel is a narrow space: the floor of the tunnel is made up by the carpal bones of the wrist, and the roof is created by the transverse carpal ligament. The median nerve is at risk for being pinched within this tunnel. If there is abnormal swelling, altered wrist anatomy, or injury to this area, the function of the median nerve may be affected.


In most cases, the cause of CTS is unknown. Thyroid disorders, rheumatoid arthritis, pregnancy, vitamin deficiencies, diabetes, fluid retention, and trauma can be associated with CTS. Women are more commonly affected than men. Repetitive, forceful gripping and heavy use of vibratory tools may increase the risk of CTS.


Patients with CTS commonly feel numbness and tingling in the fingers. Some patients feel that the fingertips are asleep or report poor circulation in the hands. Symptoms are often worse at night and people tend to shake their hands for relief. Some patients report increased symptoms while gripping a steering wheel. Dropping objects, clumsiness with the hands, or a weak grip are also common complaints. Some people also report pain in the forearm, wrist or fingers. In severe cases, the muscles at the base of the thumb (thenar muscles) can become weak and atrophy. See image below.

Often the diagnosis can be made based on your symptoms and physical examination. A nerve study can be ordered to confirm the diagnosis in some cases.


Not everyone with carpal tunnel syndrome needs surgery. Many people with CTS improve with non-operative treatment. Wearing a wrist brace at night supports the wrist in good alignment and takes pressure off the nerve. Corticosteroid injections provide an anti-inflammatory effect and can be effective in many patients. 

If nerve compression is severe, or if conservative treatment does not help, carpal tunnel surgery may be recommended. A carpal tunnel release (CTR) is performed to decrease pressure on the median nerve. During this procedure, the “roof” of the carpal tunnel (the transverse carpal ligament) is divided. Cutting the transverse carpal ligament increases the size of the carpal tunnel and provides more room for the median nerve.

The type of surgical incision varies among surgeons; however, the common goal is to reduce pressure on the median nerve. Open CTR and endoscopic CTR are two surgical options. The recommended procedure will be discussed with you with your doctor. Raleigh Hand Center physicians are experts in carpal tunnel syndrome treatment.

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