Limb position significantly affects safety distance during cast removal

Area of Science:

• Orthopedic surgery
• Patient safety

Background:

• Unintentional cast saw injuries are a risk during orthopedic procedures.
• The "safety distance" between the cast saw and patient skin is a critical factor in preventing injury.
• Improper cast removal techniques and casting materials can also contribute to injuries.

Purpose of the Study:

• To evaluate the impact of patient positioning on the safety distance during cast removal.
• To determine optimal positioning strategies to minimize skin injuries from cast saws.

Main Methods:

• Nine patients with lower leg casts (knee/ankle) were studied.
• Safety distance was measured using a depth gauge at multiple points along the limb.
• Measurements were taken in both supine and lateral-decubitus positions, defining "safe" (saw from above) and "dangerous" (saw from side) limb orientations.

Main Results:

• The mean safety distance in the "safe position" was 17.02 mm ± 4.66 mm.
• The mean safety distance in the "dangerous position" was 14.34 mm ± 3.85 mm.
• A statistically significant increase in safety distance (Δ = 2.7 mm; p < .0001) was observed in the "safe position".

Conclusions:

• Patient positioning during cast splitting is crucial for enhancing safety distance.
• Utilizing a "safe" limb position, with the saw directed from above, can significantly minimize the risk of skin injuries.
• This technique offers a practical method to improve patient safety in orthopedic cast removal.