Monday, February 25, 2008

Trust me, this won't hurt

A friend encouraged me to share this story.

A few months ago, a very scared and jittery 12 year old boy presented to the ED with a cast problem. He had broken his arm the day before and the orthopod had casted him instead of splinting the fracture. According to those who had seen him the day before, he required very heavy sedation to even approach him for reduction and casting.

His arm had swollen underneath the long arm cast and he had lost the feeling in his fingers which were swollen the size of sausage links.

I grabbed the cast saw and headed into the room. As soon as he saw the device, his eyes popped open wide and he began to retreat. I promised him that the cast saw would only cut cast material and wouldn't cut his skin. He clearly didn't believe me, and the loud rattling noise of the saw didn't help convince him of it's benign intent.

So, to put the young man at ease, I decided to put on a demonstration for him. I once again promised him that it wouldn't hurt him as I placed the blade against the back of my hand.

As I recoiled from the pain, the cast saw bounced across the back of my hand creating 3 large lacerations which instantly began to bleed. I was dumfounded! I had never been cut by a cast saw before.

The kid literally got up and ran to the corner of the room and began screaming.

We finally had to hold the kid down while I spent the better part of the next hour very carefully cutting away the cast.

Now, like Harry Potter after his encounter with Professer Umbridge, the back of my hand displays the scars from my well intentioned truth telling.

The next week, they took the cast saw away for re-calibration.


  1. Thanks for the warning. Sounds like a display I might have put on.


  2. Ah..heehawhooohaaaa...ahem...sorry, 85, no disrespect meant. While I'm very sorry you're sporting scars, the visuals of this story sent me into spasms.

  3. i've got rashes too while demonstrating the saw in orthopedics...

    i hate these demos cuz u never know when it can really cut...

    really sorry for the kid

  4. uh, erdoc85, no cast saws over thin skin/bones dude! that being said, it shouldn't have cut you. i do the same thing with the kiddos but haven't cut myself yet.

  5. I think you should test the cast saw on the clipboard "safety and quality" nurse or whatever each week.

  6. EXCELLENT K! Just brilliant. Then the'd be useful for something.

  7. Oh and if the clipboard nurse curses during her cast saw "safety test" be sure and remind her to "watch your language!" :)

  8. That poor boy sounds just like my daughter when she had her cast off last week - she had a demonstration that it wouldn't hurt by the lovely plaster technician, but it seemed he was luckier than you! Sorry to hear about your hand! And the poor boy will probably be warier about breaking bones in future ...

  9. Great minds must think alike, I tried the same stunt a few months ago. Didn't cut myself but shrieked like a little girl.

  10. I have a comment/story for the trust me this won't hurt, but it is too inappropriate even for me to write. So I'll just say I'm sorry that happened to you and that the boy saw that. How scary!

  11. Sheesh, 85- what part of "high-RPM machinery" don't you understand? This isn't the SawStop (

    (In the interest of full disclosure, I neither own a SawStop or get any money from them for saying that the equipment is great, and prevents visits to folks like 85, Cat and the rest.)

  12. Hehe, I like the Harry Potter point.

  13. This is terrible...I'm laughing as I sympathize. I've got an old cast saw that I use for sawing off guitar necks (I'm a part-time luthier) and I've managed to nick myself with it once or twice, typically forgetting that the blade is dangerous near thin skin or bony bits.

    Still, used properly, there's nothing that works's a cool and unique tool. And it cost a small fraction of the price of a Fein Multimaster...

  14. Okay after today I can kinda sympathize with the kids that don't like having their casts cut off.. I'm in ortho clinic this semester and they taught us how to put on casts today.. we partnered up (NO, not like THAT erdoc85.. get your mind out of the gutter) and casted our partner's forearm, let it dry, then 10 min later cut it off.. when my classmate went to cut off my cast with the saw I got a little anxious.. even though I knew the saw wouldn't cut me. I think its just one of those instinct things.. I don't like saws. Guess ortho isn't in my future..

  15. Jess: You can tell your future right now.

    First - stand up. Stand as tall as you can.

    Second - look down and see if your knuckles are dragging the ground.

    If the answer is "yes", then ortho is definitely in your future.

    P.S. Question: You know the difference between a carpenter and an orthopod?

    Answer: The carpenter knows more than two antibiotics!

  16. What's the 3 hardest years of training for an orthopod?

    Second grade.

  17. Do you think maybe you saved the kid from getting damaged by the saw with your well-intentioned demo?

  18. I never understood the dumb Ortho jokes, all the ones I know are braniacs who turned AOA down cause it was too low brow. I think I was mathematically eliminated from Ortho residency the first month of medical school. The only physician I've ever heard say "Duh" in the OR was a Neurologist who came in to do his evoked auditory potential thing. He couldnt figure out how the OR door worked, looked sorta like a far side cartoon.

  19. Anon: Yes. Good observation. I was actually very glad that I tried it on myself because that kid's arm was very swollen. If I had nicked his skin or lacerated it the way it lacerated me, he would have been high risk for infection from all of the crap on that blade. As it turned out, I took it VERY slowly and didn't cut him. That's why it took me almost an hour to cut the damn thing off. Normally, I have them bivalved in a matter of minutes.

    Frank: I don't know the reason for the Ortho jokes except that they often refuse to do anything except bones. They pretend not to know anything about anything else so that they don't have to deal with it. If you admit a diabetic with a broken limb, you can be certain that the O'pod will consult Medicine to "manage the sugars". You're right, they're much smarter than that...they just don't want to be bothered.

    My brother is an engineer at NASA. He said one day: "I don't know why people equate intelligence with 'rocket science'. I know lots of 'rocket scientists' who aren't all that bright". My response was that I understood where he was coming from since people say the same thing about 'brain surgery'. I know lots of neurosurgeons whose intellect is no greater than anyone else I know.

    Still the jokes are fun. A friend of mine (an O'pod) loved the second grade joke.

  20. *rofl*

    When I was a kid, they did that same demonstration for me after I argued my point of view. Hey, I was five but I wasn't stupid.