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BODYCAST
- THE OFFICIAL JOURNAL OF THE CSOT
Removing casts with ease
By Steven Cutler
Reprinted with permission from The Journal, Volume 9, Issue 1,
A publication of the National Association of Orthopaedic Technologists
Overview
For the orthopaedic technologist, casting is a part of everyday life and cast
removal is one-half of that job. Of course, there is much to know to have skilled
efficiency with this procedure. Materials, tools, and techniques are all important,
as is maintaining the comfort of the patient. The following clinical protocol
for cast removal will help you develop your skill level, whether this is your
introduction to cast removal or merely a review.
A brief history
For many centuries, broken bones have plagued mankind. Various materials were
used for immobilization in treating these injuries, such as gum/linen mix,
mud or clay, and plasterimpregnated cotton. For more than a century, plaster
of Paris rolls were the standard of care for treating broken bones and other
orthopaedic injuries. Within the past 30 years though, synthetic materials
such as fibreglass or polyester cloth impregnated with resin have replaced
plaster of Paris bandages as the primary material for immobilization.
Several rather simple methods were used to remove these early casts. Initially,
a sharp knife was used, but this was often hazardous for the patient and the
practitioner. Later, scissors or plaster shears were used to remove the hardened
bandages. They made removal safer and easier, but gave the practitioner quite
a workout. Plaster of Paris casts were routinely removed by soaking them in water
or a water/vinegar solution and then unrolling them. Unfortunately, this was
often a very timeconsuming and frustrating process.
In 1943, a revolutionary tool was invented by Dr. Homer Stryker
of Kalamazoo, Michigan. Noting the difficulty the orthopaedic practitioner
had with removing a cast by hand or soaking, he devised an electrically
powered oscillating saw to cut and remove a cast.
Instead of labouring with a pair of plaster shears or having patients
soak their limbs for hours, he could now cut the plaster of Paris
bandage rather easily with the vibrating saw blade. Even though it
was noisy, the new cast saw significantly reduced the time it took
to remove a cast. Since that time, the oscillating
This abstract is a portion of the article
which appears in the Winter 2007 issue of BodyCast.
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