Palm Thorn Injury

Palm Thorn Injury
Palm Thorn Injury

While it may seem unusual, I see a surprising number of puncture wound injuries after a freeze. It's not icicles, rather, the result of accidents that occur when people trim back their dead palm fronds! Puncture wounds are particularly susceptible to infection. It’s especially important to care for your hands when working in the yard. In today’s post, I’ll discuss how to determine if a wound is a simple annoyance, when to see a specialist, and how to prevent injuring your hands.

From cat bites to firework hand injuries, puncture wounds can seem minor, but pose serious risks of infection, and long term injury.
Brandon P. Donnelly, MD

The Problem with Puncture Wounds

As a board certified orthopedic surgeon, I've encountered a myriad of hand injuries throughout my career, each with its unique challenges and causes. From cat bites to firework hand injuries, puncture wounds can seem minor, but pose serious risks of infection, and long term injury. One such injury that  brings patients through my clinic doors after a freeze is a puncture wound from palm thorns that occurs while trying to trim back those dead palm fronds. While seemingly minor, these injuries can lead to complications if not treated promptly and properly. In this blog post, let's delve into the intricacies of palm thorn hand injuries, exploring their causes, symptoms, and the importance of seeking timely medical attention.

Understanding the Anatomy

Palm Thorn Injury | Hand AnatomyThe hand and fingers of the hand are complex structures, comprised of numerous tendons, nerves, and blood vessels that are susceptible to injury in various ways. When a thorn penetrates the skin, it can cause damage to these vital components, leading to pain, swelling, and potential complications. While palm thorn injuries are commonly associated with gardening activities, they’re even more common especially after a freeze, when gardeners are in a hurry to trim-back unsightly, dead palm leaves, and get back inside.

Causes of Thorn Injuries

Gardening enthusiasts are no strangers to thorn injuries, as thorny plants and bushes pose a constant risk. Accidental slips or missteps while working with palms, roses, bougainvillea, or other thorn-bearing plants can result in thorns deeply embedding themselves in the palm or fingers. Additionally, outdoor activities like hiking or camping may expose individuals to thorny vegetation, increasing the likelihood of injuries.


Patients with palm thorn injuries often present with immediate pain and localized swelling. These injuries can lead to tissue inflammation, synovitis, and extensive haematoma, and even Plant Thorn Arthritis. The affected area may become red and tender to the touch. In some cases, individuals may notice difficulty moving their fingers or gripping objects due to the injury's impact on the hand's functionality. If left untreated, infections can develop, leading to more severe complications, such as those of one 18-year-old male patient who presented with significant progressive swelling, and who ultimately underwent surgery to address the problem and alleviate the pain.

Treatment Options

Upon encountering a palm thorn injury, the first step is to carefully remove the thorn using sterilized tweezers. However, it's crucial to avoid squeezing the thorn, as this may lead to further injury. Cleaning the wound with mild soap and water is essential to prevent infection. Applying an antiseptic ointment and covering the wound with a sterile bandage can aid in the healing process.

In some cases, especially when thorns are deeply embedded or complications arise, seeking professional medical assistance is imperative. We may use imaging techniques like X-rays to assess the extent of the injury and determine if any foreign objects remain in the hand. Depending on the severity, surgical intervention may be required to remove thorns or address damage to tendons and nerves.

Preventive Measures

Preventing palm thorn injuries is key, and individuals can take several precautions. Wearing protective gloves while gardening or engaging in outdoor activities can significantly reduce the risk of thorn penetration. Regularly inspecting the hands for any embedded thorns after outdoor activities is also advisable.

What to do if you’ve been injured

As a doctor, I must emphasize the importance of addressing thorn injuries promptly. While many cases can be managed with basic first aid, seeking professional medical attention ensures a thorough assessment and appropriate treatment. Call my office today to schedule an appointment for an accurately diagnose your condition. I will discuss treatment therapies that may help you avoid a more serious outcome as a result of thorn related puncture wounds.

About Dr. Brandon P. Donnelly, MD

Dr. Brandon P. Donnelly is a board certified hand surgeon with Pontchartrain Orthopedics & Sports Medicine.  Dr. Donnelly completed his hand and microsurgery fellowship at the prestigious Philadelphia Hand to Shoulder Center. Dr. Donnelly treats all ages of patients in the greater New Orleans area for hand, wrist, and elbow conditions. 

This site is not intended to and does not provide medical advice, professional diagnosis, opinion, treatment or services to you or to any other individual. Through this website and links to other websites, Brandon P. Donnelly, MD provides general information for educational purposes only. The content provided in this website and links, is not a substitute for medical care or treatment. You should not use this information in place of a consultation or the advice of your healthcare provider. Brandon P. Donnelly, MD is not liable or responsible for any advice, course of treatment, diagnosis or any other information, services or product you obtain through this site.