EXHIBIT 4.2 AMENDMENT NO. 1 TO CREDIT FACILITIES AGREEMENT (THAT WAS EFFECTIVE MARCH 20, 2001) BY AND BETWEEN BANK OF AMERICA, N.A. AS ADMINISTRATIVE AGENT AND A LENDER AND THE OTHER LENDERS SIGNATORY THERETO AND YOUNG INNOVATIONS, INC. AS BORROWERCredit Facilities Agreement • August 14th, 2001 • Young Innovations Inc • Orthopedic, prosthetic & surgical appliances & supplies • Missouri
