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Limb Position Significantly Affects Safety Distance During Cast Removal

Abu-Ghanem, Yasmin; Abu-Ghanem, Nora; Albagly, Asaf; Eyal, Gil; Steinberg, Ely L.; Chechik, Ofir

doi: 10.1097/NOR.0000000000000137
Research
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BACKGROUND: Unintentional cast saw injuries are attributable to casting material or improper removal technique. Another factor associated with the risk of injury is the “safety distance,” the distance between the inner perimeter of the cast and the patient's skin.

METHODS: Nine patients with lower leg casts around the knee/ankle were examined. Safety distance was measured using a standard depth gauge at 6–10 spots along the limb. The safety distance at each spot was measured in both supine and lateral-decubitus positions. Limb position was termed “safe” with the saw coming directly from above; a “dangerous” position was considered when the saw was coming from the side.

RESULTS: The mean safety distance in the “safe position” was 17.02 mm ± 4.66 mm, compared with 14.34 mm ± 3.85 mm in the “dangerous position” (Δ = 2.7 mm; p < .0001).

CONCLUSIONS: Proper positioning of a patient during cast-splitting, with the saw in the nondependent, safe aspect of the limb, can significantly increase the safety distance and minimize skin injuries.

Yasmin Abu-Ghanem, MD, M. Med. Sc., Division of Orthopaedics, Tel Aviv Sourasky Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.

Nora Abu-Ghanem, M. Med. Sc, Division of Orthopaedics, Tel Aviv Sourasky Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.

Asaf Albagly, MD, Division of Orthopaedics, Tel Aviv Sourasky Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.

Gil Eyal, MD, Department of Orthopaedics, Beilinson Campus, Rabin Medical Center, Petah-Tiqva, Israel.

Ely L. Steinberg, MD, Division of Orthopaedics, Tel Aviv Sourasky Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.

Ofir Chechik, MD, Division of Orthopaedics, Tel Aviv Sourasky Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.

The authors declare that they have no conflicts of interest.

© 2015 National Association of Orthopaedic Nurses