How to Safely Remove a Cast With a Saw

2022-05-28 14:10:42 By : Ms. Judy Zhang

Jonathan Cluett, MD, is board-certified in orthopedic surgery. He served as assistant team physician to Chivas USA (Major League Soccer) and the United States men's and women's national soccer teams.

Miho J. Tanaka, MD, is a board-certified orthopedic surgeon who specializes in the treatment of sports medicine injuries.

A cast is often used for the treatment of a broken bone, post-surgical recovery, or other ailments that require immobilization. Casts are made of one of two materials: plaster or fiberglass. Once it is time for the cast to come off, a cast saw is used to remove it. Learn about how a cast saw works, how safe it is, and what you can do to make this a less frightening experience.

Cast saws have a sharp, small-toothed blade that rapidly vibrates back and forth. It does not spin around like a circular saw. Against the firm surface of the plaster or fiberglass, the cast saw will cut through the material. However, against your skin, the cast saw simply moves the skin back and forth with the vibration, not cutting into the skin. 

Newer cast saws have become even easier for patients to tolerate. The most significant difference is the noise coming from the motor of the saw. Older cast saws tend to have very noisy motors that can be frightening, especially for children. Newer saws have much quieter motors that cause much less anxiety for patients.

Cast saws are very safe, but they should only be used by personnel who have been trained in their proper use and how to avoid problems. Improper use of a cast saw, or use of a cast saw that has worn blades, can cause problems. Cast saws are safe, but there are possible complications of their use that can occur. Although it is possible in some cases to sustain a small skin injury or burn from a cast saw, with proper use, these injuries are not common, and there are precautions that can be taken to minimize this risk. 

There are a few problems that can occur with the use of a cast saw, and it is important that the device is used by someone knowledgeable with proper cast saw techniques. While a healthcare provider should know proper cast saw techniques, many cast techs, physician assistants, and medical assistants are also qualified in using this device.

The most common reasons patients had complications from the use of a cast saw, according to one study, were worn-out blades, insufficient cast padding, or improper training and experience. The rate of injury from a cast saw is right around 1%; therefore, the risk is small, but not nonexistent. The most common problems include the following.

If you think you have sustained an injury as a result of cast removal, let your healthcare provider know. Abrasions and burns can be better managed when your provider is aware that these may have occurred.

Many patients, especially younger children, are frightened of cast saws, but there are measures that can be taken to make the experience less traumatic.

Even with these steps, some patients are still upset and frightened. Taking time and addressing the patient's concerns can help. Unfortunately, some kids are too young to understand, and that's where a promise of an ice cream treat may be the only thing that helps get them through!

Casts are commonly used for treatment in orthopedics. Many people, at some point or another in their life, will have a cast placed for treatment of a broken bone or immobilization after surgery. While removal of the cast can provoke anxiety, it is actually a very safe procedure. A skilled cast technician will take steps to ensure that your cast is removed safely and without complications.

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Orthopaedic Product News. Breaking the mould in cast removal.

Stork NC, Lenhart RL, Nemeth BA, Noonan KJ, Halanski MA. To cast, to saw, and not to injure: can safety strips decrease cast saw injuries?. Clin Orthop Relat Res. 2016;474(7):1543–1552. doi:10.1007/s11999-016-4723-5

Shore BJ, Hutchinson S, Harris M, et al. Epidemiology and prevention of cast saw injuries: results of a quality improvement program at a single institution. J Bone Joint Surg Am. 2014;96(4):e31. doi:10.2106/JBJS.L.01372

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