The study evaluated characteristics of non-fatal mountain hiking accidents caused by falls. Questionnaires were sent to mountain hikers who suffered a fall-related accident in Tyrol (Austria) during a 3-year period. The questionnaire included details of socio-demographic data, physical activity, medication intake, defective vision, breaks, fluid intake, level of fatigue, muscle soreness, use of backpacks, use of hiking sticks, and type of shoes. Data of 405 individuals (57% females and 43% males) were included in the analyses. Victims were 56 ± 15 years of age, had a body mass index of 24.8 ± 3.5, and indicated 4.2 ± 3.9 h/week regular physical activity. A defective vision was reported by 70% of the victims, breaks were frequent (in 80%), and alcohol intake was rare (4%) among the interviewed hikers. Subjective level of fatigue was low and only 5% reported muscle soreness. A backpack was carried by 83% of the victims and the average weight was higher in males compared to females. The majority (61%) of the victims wore ankle-height hiking shoes with a profiled sole. Victims of non-fatal falls in mountain hiking are older than the general population of mountain hikers and are often afflicted with defective vision.

Introduction: The aim of this study was to evaluate the clinical and radiological outcomes of patients treated with the TFN-Advanced™ Proximal Femoral Nailing system (TFNA¸ DePuy Synthes, West Chester, PA) including intra- and postoperative complications. Materials and methods: All patients with an acute proximal femur fracture consequently treated with a TFNA between September 2014 and December 2018 were evaluated. Clinical and radiological data were assessed for intra- and postoperative complications, including treatment failure. In addition, intra- and postoperative X-rays were used to determine the position of the implant, and any migration, via tip-apex-distance (TAD) and the caput-collum-diaphyseal angle (CCD). The accuracy of the fracture reduction was rated by both observers according to Baumgartners criteria. Results: 275 consecutive patients (mean age 77.5 ± 14.1; 70.2% female) were included. The predominant OTA/AO fracture classification was 31A2 (140 cases, 50.7%). The average surgical time was 69 min (± 39.8). The reduction quality was good in 253 cases (92.0%) and acceptable in 22 cases (8.0%). In 18 cases, a pre-defined primary outcome parameter (6.5%) was recorded after a mean of 8.2 ± 8.0 months. During the observational period, 19 patients (6.9%) required a total of 23 additional surgeries. Implant removal was not considered a failure in the absence of pain. Significant group differences were observed with younger age (p = 0.001), lower Charlson Comorbidity Index (CCI)-score (p = 0.041) and lower rate of osteoporosis (p = 0.015) in the failure group. There were no cases of cut-out or cut-through among the patients who underwent augmentation as part of osteosynthesis. Conclusions: Proximal femur fractures treated with the TFNA show low complication rates and high levels of radiological healing. Implant-related complications might be more common in patients with younger age, a lower CCI-score and lower frequency of osteoporosis. Usage of cement augmentation could potentially be beneficial to reduce postoperative cut-through and cut-out.

The aim of the study was to assess the effects of the COVID-19 pandemic on sport practice and to identify measures adopted by individuals and sports organizations to allow a safe return to community sports. An electronic survey was launched worldwide in June 2020 in the German and English languages. The questionnaire collected anonymous data on sporting activity before, during, and after pandemic-induced confinement. Participants classified themselves as either recreational, competitive, or professional sports level athletes. A total of 1336 adults (30.5±11.7 years; 54.0% women) participated in the survey; 68.5% were active athletes, 10.1% coaches, 2.1% officials and 4.3% related medical staff, 3.6% had another function, and 11.4% indicated no regular sports activity. Most participants practiced their sport in Europe (93.8%); the majority (61.0%) was amateur athletes. During confinement, 15.7% could perform their main sport unrestricted, 43.5% stated a reduced amount of time spent on sporting activities, 46.4% a reduced intensity level. Most participants (77.5%) were neither aware of screening measures nor of guidelines for dealing with infected athletes (80.0%) or for return to sports after a coronavirus infection (88.6%). Preventive measures mentioned included basic hygiene, measures to reduce personal contacts or virus transmission, or to improve traceability of infections. During confinement, a higher age (p=0.004) and training in a club setting (p<0.001) were associated with reduced sporting activity, while the availability of online training (p=0.030) was linked to both increased extent and intensity levels. A lower age (p=0.001) and recreational sports level (p=0.005) were associated with decreased activity after confinement. Although isolation can be necessary to protect public health, it alters the amount and intensity of physical activity.

Emergency interhospital transfer can be conducted using either ground-based emergency medical services (GEMS) or helicopter emergency medical services (HEMS). The choice between these modes of transportation relies mostly on urgency and transfer distances, however they are further influenced by road traffic, weather and resource availability. While some studies suggest that HEMS may improve survival rates for severely injured patients, the time efficiency of HEMS versus GEMS across varying distances remains underexplored. This retrospective clinical cohort study analyzed 1784 emergency interhospital transfers from 11 hospitals to Innsbruck University Hospital in Austria, over a 10-year period (2013-2023), comparing efficiency of GEMS and HEMS across distances from 11 hospitals within a 115 km radius. Outcome assessment included time duration of distinct phases of transfer, including dispatch time, isolated transport duration, overall transfer duration, total resource occupancy time, and cost efficiency. HEMS was primarily used for longer distances, while GEMS were almost exclusively used for transports 50 km away, the mean overall transfer duration was 58.1 (± 16.5) minutes for HEMS and 77.1 (± 20.3) minutes for GEMS (p < 0.001). For hospitals within 50 km, the mean overall transfer duration was 46.4 (± 13.9) minutes for HEMS and 44.0 (± 12.9) minutes for GEMS (p = 0.175). Cost analysis revealed that HEMS was significantly more expensive than GEMS, with a cost disparity of up to 17 times the cost per route. GEMS is more efficient and should be considered for all transfers under 30 km, while HEMS offers a time advantage for distances exceeding 50 km, providing potentially crucial time savings in time-critical cases. For intermediate distances, HEMS may be justified when reducing treatment delays is essential. Decisions regarding transport modality should consider not only the distance but also urgency and the potential clinical benefits of faster treatment. Future studies should examine the clinical outcomes of different transfer modes to better guide transport decisions.

Rapid weight loss strategies and weight cycling (losing and gaining weight repeatedly) are acknowledged problems in sports with weight categories, including judo. Extreme fasting, especially if combined with dehydration and intense physical exercise, may harm health and development, particularly those of children and teenagers engaging in judo competitions. However, there is substantial evidence for positive health effects of other forms of fasting. Here, we aim to provide an updated overview of the potential health risks associated with extreme dietary strategies in judo and contrast them with health-promoting fasting approaches. We conclude that the literature on the long-term health consequences of fasting in judo is scarce. This applies specifically to its potential association with eating disorders. Although many reports have highlighted the short-term risks of rapid weight loss, vulnerability and protection factors remain poorly understood. Rigorous scientific studies are needed to disentangle the factors that render fasting in judo healthy or unhealthy, considering both physical and mental health. We argue that a better understanding of weight management in judo is crucial to preventing health risks and designing healthy weight loss strategies, especially for young athletes.

Background/Objectives: Mixed martial arts (MMA) is a popular full-contact combat sport. The aim of this study was to determine injury mechanisms, rates, severity, patterns, circumstances, and the resulting economic healthcare consequences by conducting a detailed survey of competitive and recreational athletes. Methods: In 2023, MMA athletes were retrospectively questioned regarding their injuries in the last 24 months and the resulting healthcare impact (medical attention, hospitalization, incapacity to work). An injury was defined as any physical complaint resulting from MMA exposure. The severity of the injury was categorized according to the resulting restriction of sport participation (i.e., ‘severe’: more than four weeks of restriction). Results: A total of 112 participants (93% male; 41% non-competitive and 59% competitive) were included. All in all, 93,857 h of MMA activities were performed, and 127 injuries were recorded, resulting in an overall injury rate of 1.4 injuries per 1000 h of exposure. Non-competitive athletes reported significantly fewer total injuries in the past 24 months (95% CI 0.87–2.04; p = 0.003) and had significantly fewer severe or even critical injuries compared to competitive athletes (OR 0.55; 95% CI 0.21–1.43; p = 0.042). Head- and neck lesions (20%) were the most common injuries. The most common types of injury were joint sprains (21%) and ligament strains (17%). The healthcare burden of these sports-related injuries was minimal: By median, injuries led to zero days of hospitalization and incapacity to work, with no statistically significant differences between recreational and competitive athletes. Conclusions: Competitive athletes suffer more severe injuries compared to recreational athletes. Overall, injuries in MMA are rare, and the economic impact and burden on the healthcare system are negligible compared to other sport disciplines.