How to Avoid Cast Saw Complications

@article{Halanski2016HowTA,
  title={How to Avoid Cast Saw Complications},
  author={Matthew A. Halanski},
  journal={Journal of Pediatric Orthopaedics},
  year={2016},
  volume={36},
  pages={S1–S5}
}
  • M. Halanski
  • Published 1 June 2016
  • Medicine
  • Journal of Pediatric Orthopaedics
Background: As casts are routinely used in pediatric orthopaedics, casts saws are commonly used to remove such casts. Despite being a viewed as the “conservative” and therefore often assumed safest treatment modality, complications associated with the use of casts and cast saws occur. Methods: In this manuscript, we review the risk factors associated with cast saw injuries. Results: Cast saw injuries are thermal or abrasive (or both) in nature. Thermal risk factors include: cast saw… 

Establishing Safety Parameters for Orthopaedic Cast Saw Blade Usage

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Having Patience With Our Patients: A Key Technique in Cast Saw Burn Prevention

A minimum of 7 minutes of set time for a fiberglass cast before attempting to bivalve using segmented cuts is associated with the smallest increase in temperature of the saw blade.

Cast Saw Burn Prevention: An Evidence-Based Review.

A review of currently published data provides clinicians with a summary of the literature to guide practice based on the best available evidence, with the goal of preventing iatrogenic cast saw burns.

Current Complications of Cast Removal with Oscillating Saws and a Novel Method for Reducing Such Complications: A Comparative Clinical Study.

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Eliminating saw blade-to-skin contact with a tong-like, externally guided flexible steel aid provides a high level of safety, decreases removal time by 5 to 10 minutes (depending on cast length), and makes cast removal a better experience for both patients and operators.

Neuromuscular Patients Are 40% More Likely to Get a Cast Injury

The incidence of cast injuries is 12.5 per 1000 children at the authors' level I trauma tertiary referral pediatric clinic and patients with neuromuscular disorders are at significantly higher risk for experiencing cast injuries.

Alternatives to Traditional Cast Immobilization in Pediatric Patients.

The disadvantages of traditional casting can be minimized by alternative management strategies: waterproof casts to facilitate bathing and swimming; a Pavlik harness in infants, a single- leg spica cast, or flexible intramedullary nails to avoid complications with double-leg spica casts for femur fractures.

A Comparison of Casting Versus Splinting for Nonoperative Treatment of Pediatric Phalangeal Neck Fractures

A retrospective study of patients aged 18 and below with phalangeal neck fractures treated nonoperatively from 2008 to 2017 finds no significant difference in clinical and radiologic outcomes between children who were treated in casts and those treated in removable splints.

Ponseti Cast Removal: Video Technique

Cast soakage with lukewarm water followed by unwrapping is a simple and cost-effective method of Ponseti cast removal which can be done by parents at home improving the overall satisfaction of the family.

Novel Cast-saw Alarm System Reduces Blade-to-Skin Contact in a Pediatric Upper Extremity Model

Blade-to-skin contact can be reduced with the use of a cast-saw alarm, however, alarm use significantly reduced the number of touches of >0.5 seconds duration in users with little prior cast- Saw experience.

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Excessively thick plaster and a dip-water temperature of >24 degrees C should be avoided and overwrapping of plaster in fiberglass should be delayed until the plaster is fully cured and cooled.

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