Throughout my 11 years in orthopedics, I have put casts on a considerable number of young children with wrist or forearm fractures. Many of them are terrified of the cast saw, which makes removal quite challenging.

In an effort to make the experience less scary, I tell them that it is going to sound like mommy’s vacuum cleaner. Next, I tell them that it is going to tickle like crazy, so try not to laugh. Sure enough, most giggle right through the whole thing. — Sandra Radcliff, PA-C, St. Thomas, Virgin Islands (157-13)

These are letters from practitioners around the country who want to share their clinical problems and successes, observations and pearls with their colleagues. We invite you to participate. If you have something you would like to share, send us an email.