How to avoid cast saw complications

Research output: Contribution to journalArticlepeer-review

11 Scopus citations


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 specifications (including a lack of attached vacuum), use of a dull blade, cutting in a concavity, too thin padding, and overly thick casting materials. Risk factors associated with abrasive injuries include: sharp blades, thin padding, and cutting over boney prominences. Because nearly all clinicians contact the skin with the blade during cast removal, appropriate "in-out technique" is critical. Such technique prevents a hot blade from remaining in contact with the skin for any significant time, diminishing the risk of burn. Similarly, using such technique prevents "dragging the blade" that may pull the skin taught, cutting it. It may be useful to teach proper technique as perforating a cast rather than cutting a cast.

Original languageEnglish (US)
Pages (from-to)S1-S5
JournalJournal of Pediatric Orthopaedics
Issue number4
StatePublished - 2016
Externally publishedYes


  • cast
  • cast saw
  • iatrogenic
  • injury
  • prevention

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Orthopedics and Sports Medicine


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