J Emerg Med
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Comparative Study Clinical Trial
A beveled, conventional cutting edge surgical needle: a new innovation in wound closure.
A new beveled, conventional cutting edge needle has been developed with superior performance characteristics over those of other conventional cutting edge needles. It is composed of a unique stainless steel, ASTM 45500, that has been heat-treated after the curving process to enhance its resistance to bending. The angle of presentation of its cutting edges has been decreased to enhance needle sharpness. On the basis of the results of experimental and clinical investigations, this new needle is recommended for closure of lacerations.
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Radial head subluxation (RHS) produces no radiographic abnormalities according to most experts. However, recent anecdotal case reports have identified displacement of the radiocapitellar line (RCL) in pediatric patients with RHS. To verify this finding, we retrospectively reviewed all patients less than 5 years of age who received elbow and forearm radiographs in our emergency department. ⋯ The presence of RCL displacement without disruption of the radiocapitellar articulation confirms the diagnosis of RHS, but does not appear to change treatment or outcome in this subset of patients. In addition, radiographs may not be mandatory when the diagnosis of RHS is certain. We suggest obtaining radiographs if the history (i.e., fall) or physical examination is atypical or if reduction is unsuccessful to rule out more serious injuries such as radial head dislocation or fracture.
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A zipper-entrapped penis is a painful predicament that can be made worse by overzealous intervention. Described is a simple, basic approach to release, that is the least traumatic to both patient and provider.