What is Bivalve Cast?

Bivalve cast means the cast cut into two halves. This might be required in cases where frequent inspection in the cast is required, patient is to be put on range of motion exercises or a patient

Position the patient. Depending on the type of cast applied his cast, it could be sitting or lying down. Patient is covered with linen  and position the patient’s limb appropriately. Position of the limb may be changed during the procedure as required.

Assure the patient that procedure is safe, the saw does not cut the skin as it vibrates. But do warn the patient about saw blade getting hot as it sometimes may cause discomfort.

A plastic skin protector strip may be inserted between the cast lining and patient’s limb in the area where cutting will occur. This would protect the skin further from blade injury.
Bivalve cast

The first cut should be made downwards and slightly sideways at approximately 30°. After the first cut, all subsequent cuts should be made straight down into the cast. As the plaster gets cut, it gives way and the reaction of the person cutting should be to immediately lift back the cutter as it gives way.

Cutting proceeds in a series of cuts applying downward pressure through the blade until a loss of resistance is felt. The blade is removed completely from the cast, the blade rotated slightly before proceeding to the next cut.This would avoid excessive heating or blunting of the blade. Saw blade should not be run along the cast. Instead  an up and down action is employed.

Using plaster spreader and shear, underpadding is cut.

Once the cast has been split, another cut is marked on directly opposite side of the cast for making it bivalve cast.

Following bivalving of cast, the halves of the bivalve cast are secured in place with bandage.

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