title: The anterior aspect is the safest area to split a leg cast in the supine position: a study protocol.
abstract: BACKGROUND
  Involuntary cast-saw burns are attributable to poorly padded casts, cast material, or improper technique. Another factor potentially associated with the risk of injury is the distance between the inner perimeter of the cast and the patient's skin (safety distance).
  
  
  METHODS
  Eighty computed tomographic scans of the lower limb following cast application were analyzed. Safety distance was measured above, below, and at the level of the knee and ankle joints at 4 different aspects (posterior, anterior, medial, and lateral).
  
  
  RESULTS
  The highest safety distance measured was at the anterior aspect, 5 cm beneath the ankle joint (8.13 ± 3.73 mm). The lowest distance measured was consistently at the posterior aspect at all levels, especially 5 cm below the ankle joint (2.02 ± 1.31 mm).
  
  
  CONCLUSIONS
  The anterior aspect of the leg is the safest area to split a cast based on safety distance measurements. Patient and limb position may also affect the safety distance at various areas along the limb.
authors.affiliation: 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. Ely L. Steinberg, MD, Division of Orthopaedics, Tel Aviv Sourasky Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel. Eran Maman, MD, Division of Orthopaedics, Tel Aviv Sourasky Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel. Michael Drexler, 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.
authors.forename: Yasmin
authors.initials: Y
authors.lastname: Abu-Ghanem
authors.forename: Ely L
authors.initials: EL
authors.lastname: Steinberg
authors.forename: Eran
authors.initials: E
authors.lastname: Maman
authors.forename: Michael
authors.initials: M
authors.lastname: Drexler
authors.forename: Ofir
authors.initials: O
authors.lastname: Chechik
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002370:Casts, Surgical; D002648:Child; D005260:Female; D006801:Humans; D007866:Leg / Q000000981:diagnostic imaging; D008297:Male; D008875:Middle Aged; D056888:Patient Positioning; D014057:Tomography, X-Ray Computed; D055815:Young Adult