RESUMO
Background Humeral shaft fractures are common orthopedic injuries, and their treatment options vary based on fracture characteristics. One surgical method involves closed reduction and internal fixation (CRIF) with multiple intramedullary (IM) Kirschner wires (K-wires), which remains less explored, especially in adults. This study aims to investigate the outcomes of the treatment of humeral shaft fractures by closed reduction and internal fixation with multiple flexible intramedullary K-wires. Materials and methods We conducted a retrospective study at King Abdulaziz Medical City, Riyadh, Saudi Arabia, focusing on patients with traumatic humeral shaft fractures who underwent flexible intramedullary K-wire fixation. We analyzed nine patient records for demographic information, fracture location, type, mechanism of injury, intra-operative and post-operative factors, and complications. Results Fractures mostly affected the middle third of the humerus (55.6%) and were primarily transverse or oblique (77.8%). Motor vehicle accidents were the leading cause of injury (66.7%). Intra-operative time was 125 minutes on average, with minimal blood loss (78 mL). No participants required intra-operative blood transfusion. Complications following IM K-wire fixation were absent in all cases. Three patients had not yet undergone instrumental removal, and most reported mild or no pain during the final follow-up. All participants achieved a full range of motion for their elbows. All participants achieved complete radiological and clinical union (healing) of their fractures. Conclusion The use of multiple intramedullary K-wires for the treatment of humeral shaft fractures in this study demonstrated positive outcomes with low complication rates. This approach provides an effective option for managing these fractures, particularly in cases where surgical indications favor it.
RESUMO
Introduction Studying medical science is a demanding task, often leading to exam anxiety among medical students. This study aims to measure anxiety levels among medical students and their relationship with gender, age, grades, study time, year of study, and learning methods. Methods It is a cross-sectional study involving third- to sixth-year medical students, who filled in the questionnaire related to the personal data, studying methods, and the Westside Test Anxiety Scale, to estimate the exam anxiety levels before the final examinations of the academic year 2020-2021. Completed questionnaires were reviewed, entered in Microsoft Excel, and analyzed using SPSS. Results We found a significant association between gender and high-test anxiety (p < 0.001), with a higher prevalence among females (47.9%) compared to males (22.5%). Although non-significant, its prevalence was higher among the 20 years old (34%) and those with a GPA 4.00-4.49 (37.9%). Anxiety decreased as the students progressed to higher years of studies (37.9% in the third year to only 9.1% in sixth year, p=0.073), with the lower incidence among those who studied five days or more per week (26.7%) and no significant difference was observed whether students studying in a group or individually. Though insignificant (p=0.754), learning through textbooks was found to be less stressful (29% vs 33%). Conclusion Our findings suggest that mediocre and female students are more vulnerable to exam high-test anxiety. Progression to senior years and use of textbooks were associated with lower anxiety levels. A cohort longitudinal study to establish an association between specific factors and anxiety levels is recommended.
