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E ven our simplest interventions expose patients to risk. Acetaminophen, even in moderate doses, can cause liver damage [2]. One population study suggested that nearly half of all cases of septic arthritis—a potentially life-threatening surgical emergency—are iatrogenic, related to joint injections and arthroscopic surgery [4]. Even generally well-tolerated treatments can result in serious harm and healthcare expenditures across a population when they are not used thoughtfully [9]. Although casting fractures usually is safer than, and for some injuries can be as good or better than, surgery, even wellapplied casts can cause problems. Tight casts and dressings remain in the front of surgeons’ minds, but cast removal, usually delegated to the junior-most team member or a technician, is anxiety-provoking [7], sometimes painful, and occasionally injurious to the patient [1]. Cuts and burns from cast saws can result in disfiguring wounds, and in one study [8], cast-related complications were the leading cause of litigation against a large pediatric multispecialty care group. Although less-experienced handlers of the cast saw have been implicated as the problem in some studies [13], training and education alone seem insufficient to eliminate the risks [10]. Soaking casts off may work for plaster [12], but it is tedious, messy, and ineffective for fiberglass casts. Although soft-roll cast padding can help [14], excessive amounts of cotton roll cannot be the solution; too much padding results in ineffective casting and loss of reduction when the cast needs to be molded to maintain the position of a fracture [3, 6]. There are no high-tech approaches on the horizon; million-dollar medicine is no help here. Solving this problem will take ... a few bucks worth of synthetic ribbon? Apparently so. Matthew A. Halanski MD and his team at the University of Wisconsin have spent the last several years developing a realistic model to determine whether a cast saw would have risked cutting or burning a child’s arm in the course of cast removal— without subjecting any child to risk or harm. They then tested a barrier method using what the manufacturer describes cryptically if accurately as ‘‘proprietary blue material’’ placed beneath the cast, and found that it dramatically reduced the risk of laceration or thermal injury in Note from the Editor-In-Chief: In ‘‘Editor’s Spotlight,’’ one of our editors provides brief commentary on a paper we believe is especially important and worthy of general interest. Following the explanation of our choice, we present ‘‘Take Five,’’ in which the editor goes behind the discovery with a one-on-one interview with an author of the article featured in ‘‘Editor’s Spotlight.’’ The author certifies that he, or any members of his immediate family, has no commercial associations (eg, consultancies, stock ownership, equity interest, patent/licensing arrangements, etc) that might pose a conflict of interest in connection with the submitted article. All ICMJE Conflict of Interest Forms for authors and Clinical Orthopaedics and Related Research editors and board members are on file with the publication and can be viewed on request. The opinions expressed are those of the writers, and do not reflect the opinion or policy of CORR or The Association of Bone and Joint Surgeons. This comment refers to the article available at: DOI: 10.1007/s11999-016-4723-5.

Editor's Spotlight/Take 5: To Cast, to Saw, and Not to Injure: Can Safety Strips Decrease Cast Saw Injuries?