Patient-Reported and Clinical Outcomes After Tendon Autograft Reconstruction of the Thumb Ulnar Collateral Ligament.

PURPOSE: This study aimed to report clinical and patient-reported outcomes collected in a registry after thumb ulnar collateral ligament (UCL) reconstruction with a free tendon autograft. Furthermore, the patient-reported outcomes of patients with persistent instability after reconstruction and patients with concomitant metacarpophalangeal joint arthritis diagnosed during surgery were analyzed. METHODS: Patients undergoing reconstruction with a tendon autograft between December 2011 and February 2021 were included. Michigan Hand Outcomes Questionnaire (MHQ) scores at baseline were compared with those at 3 and 12 months after surgery. Stability was tested at 3 months after surgery. Tip and key pinch strength and metacarpophalangeal joint range of motion were measured at baseline and 12 months after surgery. RESULTS: We included 31 patients with thumb UCL insufficiency or failed UCL surgery who underwent reconstruction. The MHQ total score improved significantly from 62 at baseline to 75 at 3 months and continued to increase to 84 at 12 months after surgery. The MHQ function and pain scores improved significantly from intake to 3 and 12 months after surgery. Twenty-six of 31 patients (84%) regained postoperative metacarpophalangeal stability. Key pinch strength improved significantly 12 months after surgery from 5.2 kg at baseline to 6.4 kg at 12 months. The MHQ total, pain, and function scores of patients with persistent instability remained similar from baseline to 12 months after surgery. In four patients with metacarpophalangeal arthritis, the MHQ total and pain score improved significantly from baseline to 3 and 12 months after surgery. CONCLUSIONS: Patient-reported outcomes, including pain and function, improved after thumb UCL reconstruction with a tendon autograft. Although the sample size of patients with thumb metacarpophalangeal arthritis diagnosed during surgery was small, they reached adequate patient-reported outcomes at 12 months after surgery. TYPE OF STUDY/LEVEL OF EVIDENCE: Therapeutic IV.

Clinical outcomes after primary repair for thumb ulnar collateral ligament ruptures: a systematic review and meta-analysis.

There is no consensus on the best surgical technique for treating thumb ulnar collateral ligament (UCL) ruptures. This systematic review and meta-analysis investigates which primary repair technique and postoperative immobilization protocol result in the best clinical outcomes. A literature search was conducted in Embase, Medline ALL Ovid, Web of Science Core Selection and Cochrane Central Register of Controlled Trials. Pain, stability, tip pinch strength, key pinch strength, grip strength, return to work and metacarpophalangeal joint range of motion were collected as postoperative outcomes. In total, 29 studies were included. All surgical techniques resulted in satisfactory clinical outcomes, with no significant differences between bone anchor reinsertion, suture fixation, K-wire fixation and a combination of techniques. K-wire immobilization resulted in worse postoperative pain, but similar stability compared to immobilization without a K-wire. Clinical outcomes after thumb UCL repair are excellent, with no differences in clinical outcomes noted among surgical techniques.

U-shaped kirschner wire transfixation: effective treatment for Skier's thumb.

BACKGROUND: Skier's thumb is a type of injury to the ulnar collateral ligament of the metacarpophalangeal joint of the thumb, which can result in bone fragmentation and joint instability. OBJECTIVE: The objective of this study was to compare the traditional Kirschner wire fixation method with the U-shaped Kirschner wire method for treating small bone fragments with displacement, rotation, or instability in skier's fractures. METHOD: A retrospective study was conducted on 30 patients with skier's thumb who were treated at Tianjin Hospital from January 2019 to December 2021. Patients were divided into two groups: Group A received traditional Kirschner wire fixation, while Group B received U-shaped Kirschner wire fixation. Functional assessments and complications during the perioperative period were evaluated. RESULTS: Both surgical methods significantly reduced postoperative pain and increased joint range of motion. Group B had a lower incidence of pain during follow-up and showed significant functional improvement in Tip-pinch and Grip tests compared to Group A. U-shaped Kirschner wire fixation significantly reduced complications during the perioperative period. CONCLUSION: The U-shaped Kirschner wire internal fixation is a safe and effective treatment for the thumb proximal phalanx base ulnar side avulsion fracture.

A Study of the Training Load of Chinese Men Cross-Country Skiers in the Winter Olympic / Un estudio de la carga de entrenamiento de los esquiadores de fondo chinos en los Juegos Olímpicos de Invierno

This study examines the training load and performance of Chinese male cross-country skiers in preparation for the 2022 Winter Olympics. The research aims to establish a solid foundation for organising training loads and managing competitive readiness in Chinese cross-country skiing competitions. The study used quantitative data from four Chinese male athletes during the preparation period for the Beijing Winter Olympic Games in 2021. The Garmin 945 heart rate monitor was used to observe and document the training load, including factors such as training content, duration, distance, intensity level, and timing. The index test method was employed to assess the athletes' blood index at biweekly intervals. The Chinese skiers underwent a general preparation period that lasted 164 days, a special preparation period that lasted 70 days, and a pre-competition period that lasted 26 days. The overall training volume exceeded that of world-class athletes, with a notable emphasis on terrestrial training. The prevalence of endurance training was lower in comparison to world-class athletes, with a greater emphasis on strength training. The training intensity exhibited a modest increase, with a distribution pattern of low, medium, and high levels of intensity. The frequency of training and land training declined from the general preparation period to the pre-competition period, while the frequency of snow training increased. The intensity of the competition arrangement during the special preparation period was heightened.(AU)

Avalanche Education Is Associated with Increased Avalanche Safety Practices in the New Hampshire Backcountry.

INTRODUCTION: Avalanche risk can be mitigated by adhering to certain safety practices. Previous studies of these practices have focused on western United States and European cohorts. We conducted a survey of backcountry users in the White Mountains of New Hampshire to determine local adherence to 5 previously studied avalanche safety practices. We assessed whether participants were carrying transceiver, probe, and shovel (TPS); had formal avalanche education; had awareness of the day's avalanche danger level; had a route plan; and were traveling in a group. METHODS: Backcountry users in the White Mountains were directed to an online survey from December 2020 to June 2021. The survey was completed individually and queried demographics and avalanche safety practices. RESULTS: A total of 133 users participated. Not all surveyed participants answered all questions. Avalanche training was reported by 87% of users, 86% checked the avalanche forecast prior to recreating, 93% had a travel plan, 87% traveled in a group, and 59% carried TPS. All 3 items were carried by all group members only 48% of the time. Only 28% of users met all 5 safety practices. CONCLUSIONS: White Mountains backcountry users are less likely to meet avalanche safety practices than users in previous studies. There is an association between meeting these defined safety practices and formal avalanche education.

Management of Complex Hand and Wrist Ligament Injuries.

Ligamentous injuries in the hand and wrist are often underdiagnosed and can present with significant functional limitations if there is untimely recognition of injury. Adequate repair or reconstruction is critical in restoring joint stability and mobility. The purpose of this review is to provide an overview of the metacarpophalangeal joint, scapholunate interosseous ligament (SLIL), and non-SLIL carpal ligament anatomy, diagnosis, imaging, treatment consideration and options, as well as surgical techniques encompassing repair, reconstruction, and fusion.

Patient-Reported Outcomes and Function After Surgical Repair of the Ulnar Collateral Ligament of the Thumb.

PURPOSE: The purpose of this study was to report prospectively collected patient-reported outcomes of patients who underwent open thumb ulnar collateral ligament (UCL) repair and to find risk factors associated with poor patient-reported outcomes. METHODS: Patients undergoing open surgical repair for a complete thumb UCL rupture were included between December 2011 and February 2021. Michigan Hand Outcomes Questionnaire (MHQ) total scores at baseline were compared to MHQ total scores at three and 12 months after surgery. Associations between the 12-month MHQ total score and several variables (i.e., sex, injury to surgery time, K-wire immobilization) were analyzed. RESULTS: Seventy-six patients were included. From baseline to three and 12 months after surgery, patients improved significantly with a mean MHQ total score of 65 (standard deviation [SD] 15) to 78 (SD 14) and 87 (SD 12), respectively. We did not find any differences in outcomes between patients who underwent surgery in the acute (<3 weeks) setting compared to a delayed setting (<6 months). CONCLUSIONS: We found that patient-reported outcomes improve significantly at three and 12 months after open surgical repair of the thumb UCL compared to baseline. We did not find an association between injury to surgery time and lower MHQ total scores. This suggests that acute repair for full-thickness UCL tears might not always be necessary. TYPE OF STUDY/LEVEL OF EVIDENCE: Therapeutic II.

Thumb metacarpophalangeal joint morphology and reconstruction of the ruptured ulnar collateral ligament.

Studies on graft reconstruction techniques for ruptured thumb metacarpophalangeal (MCP) ulnar collateral ligaments (UCL) do not consider the variety of MCP joint morphology. Optimal reconstruction method for flat MCP joints is therefore unclear. Twenty-four fresh-frozen, human thumbs were tested for flexion, extension and valgus stability of the MCP joint. After resection of the UCL, four reconstruction methods, differing in the metacarpal origin and phalangeal attachment, were performed on each specimen, which were then tested again in the same way. Specimens were grouped as 'round' or 'flat' depending on morphometric parameters and group differences were analysed. In flat joints, only the non-anatomical Glickel reconstruction and a modified Fairhurst reconstruction maintained normal mobility and stability. In round joints, only the Glickel reconstruction maintained normal mobility and stability. The original Fairhurst method and a modification with the origin palmar in the metacarpus were disadvantageous in both flat and round joints.

Pseudo-Stener lesion due to proximal ulnar collateral ligament rupture: A case report.

INTRODUCTION AND IMPORTANCE: Ulnar collateral ligament (UCL) ruptures are a common injury of the thumb. The UCL will most commonly rupture at the distal insertion. It has been proposed that a partial or non-displaced tear can be managed non operatively. However, a complete rupture that occurs at the distal insertion will commonly not be able to heal non-operatively due to the interposition of the adductor aponeurosis. This clinical finding is known as a Stener lesion, first described by Bertil Stener in 1962. CASE PRESENTATION: We present the case of a 63-year-old-woman with instability of the thumb, pain, and a small mass at the ulnar side of the metacarpal phalangeal joint (MCPJ). CLINICAL DISCUSSION: A Stener lesion mass is commonly palpated on the ulnar MCPJ due to the ligament being trapped proximally to the overlying aponeurosis. Our patient mistakenly presented with a Stener lesion that was intraoperatively discovered to be a mass of granulation tissue. This patient underwent repair of the UCL and was able to return to unrestricted daily activities after six weeks. CONCLUSION: This case highlights an unusual rupture pattern and shows the proper surgical techniques for repairing such an injury. It is imperative to restore joint stability to prevent decreased grip strength and early onset of osteoarthritis of the MCPJ. LEVEL OF EVIDENCE: Therapeutic Level 3B.

Musculoskeletal Ultrasound Image-Based Radiomics for the Diagnosis of Achilles Tendinopathy in Skiers.

OBJECTIVES: Our study aimed to develop and validate an efficient ultrasound image-based radiomic model for determining the Achilles tendinopathy in skiers. METHODS: A total of 88 feet of skiers clinically diagnosed with unilateral chronic Achilles tendinopathy and 51 healthy feet were included in our study. According to the time order of enrollment, the data were divided into a training set (n = 89) and a test set (n = 50). The regions of interest (ROIs) were segmented manually, and 833 radiomic features were extracted from red, green, blue color channels and grayscale of ROIs using Pyradiomics, respectively. Three feature selection and three machine learning modeling algorithms were implemented respectively, for determining the optimal radiomics pipeline. Finally, the area under the receiver operating characteristic curve (AUC), consistency analysis, and decision analysis were used to evaluate the diagnostic performance. RESULTS: By comparing nine radiomics analysis strategies of three color channels and grayscale, the radiomic model under the green channel obtained the best diagnostic performance, using the Random Forest selection and Support Vector Machine modeling, which was selected as the final machine learning model. All the selected radiomic features were significantly associated with the Achilles tendinopathy (P < .05). The radiomic model had a training AUC of 0.98, a test AUC of 0.99, a sensitivity of 0.90, and a specificity of 1, which could bring sufficient clinical net benefits. CONCLUSIONS: Ultrasound image-based radiomics achieved high diagnostic performance, which could be used as an intelligent auxiliary tool for the diagnosis of Achilles tendinopathy.

Effects of physical stress in alpine skiing on psychological, physiological, and biomechanical parameters: An individual approach.

Alpine skiing is an attractive winter sport that often includes mental and physical demands. Since skiing is often done for several hours, fatigue processes occur that might lead to action errors associated with a higher risk of accidents and injuries. The aim of this study was to investigate the timing of changes in subjective, physiological, and biomechanical parameters during a physically demanding, standardized, non-competitive alpine skiing session. A group of 22 experienced male skiers carried out 10 runs, each lasting between 150 and 180 s, at a turn rate of 80 turns per minute with their best skiing technique. Immediately after the run, skiers reported ratings of fatigue, and other affective states. During skiing, breathing pattern and biomechanical data of the ski turns as radial force, turn duration, edge angle symmetry, and a composed motion quality score were recorded. Analyses of variances on skiers showing signs of fatigue (n =16) revealed that only the subjective data changed significantly over time: fatigue and worry increased, vitality and calm decreased. Subsequently, individual change points analyses were computed to localize abrupt distribution or statistical changes in time series data. For some skiers, abrupt changes at certain runs in physiological and/or biomechanical parameters were observed in addition to subjective data. The results show general effects in subjective data, and individual fatigue-related patterns concerning the onset of changes in subjective, physiological, and biomechanical parameters. Individuality of response to fatigue should be considered when studying indicators of fatigue data. Based on the general effects in subjective data, it is concluded that focusing on self-regulation and self-awareness may play a key role, as subjective variables have been shown generally sensitive to the physical stress in alpine skiing. In the future, customized algorithms that indicate the onset of fatigue could be developed to improve alpine skiers' self-awareness and self-regulation, potentially leading to fewer action errors.

Primary Results of Hook Plate Fixation Technique for Ulnar Collateral Ligament Fracture-Avulsion: A Case Study.

Background: Ulnar collateral ligament(UCL) fracture-avulsion of the thumb which involves small osseous fragments is among common injuries to the thumb metacarpophalangeal (MCP) joint. Methods: This case series was conducted on 11 patients (9 males and 2 females) with a mean age of 25.4±4.8 years with acute traumatic UCL fracture-avulsion with instability and Stener Lesion. A low-profile 2-mm stainless steel hook plate with a 2-mm screw was used for the internal fixation. Immobilization was performed for 10 days. Range of motion movements (ROM), grip power, and pinch strength were measured after three months. At the end of the follow-up period, functional outcomes were determined by the visual analog scale (VAS), and Quick Disabilities of the Arm, Shoulder, and Hand (Quick DASH). Results: The mean follow-up period was reported as 12.4±2.3 months. the union of avulsed small osseous fragments occurred at the end of the three-month follow-up. A number of 10 patients were treated by one hole 2-mm plate with a screw and a mean VAS score of 22.5±2.4, while a female patient had more severe pain with a mean score of 45. This patient complained about the irritation of the plate, especially in the thumb grip. The mean Quick DASH score was 9.6±1.4. The postoperative ROM was similar to that of the other side. Grip power and pinch strength were lower in the treated thumb, as compared to that in the opposite side; nonetheless, the difference was not statistically significant. Conclusion: As evidenced by the obtained results, it can be concluded that the hook plate technique is a strong fixation method for thumb UCL fracture-avulsion, raising the possibility of earlier joint movements and rapid recovery; nevertheless, in some cases, it can reduce efficiency and induce painful grip.

Femoroacetabular Impingement in Elite Skiers and Snowboarders: Return to Sports and Outcomes After Hip Arthroscopy.

BACKGROUND: Hip arthroscopy has been shown to be an effective treatment for femoroacetabular impingement (FAI) in high-level athletes; however, limited outcome and return-to-play data exist for hip arthroscopy in skiers and snowboarders. PURPOSES: To determine the return-to-sports rate of elite skiers and snowboarders who have undergone hip arthroscopic surgery for FAI and to assess hip-related outcomes at a minimum 2-year follow-up. STUDY DESIGN: Case series; Level of evidence, 4. METHODS: Elite skiers and snowboarders who underwent hip arthroscopy for the treatment of FAI between 2005 and 2018 were identified via a retrospective review of prospectively collected data. Data were obtained from fis-ski.org, usskiandsnowboard.org, xgames.com, and wikipedia.org, including information on each player's career length, participation on a national team, and time between surgery and first competition after surgery. Patient-reported outcomes (PROs) were prospectively collected preoperatively and at minimum 2 years postoperatively. RESULTS: In total, 26 elite skiers and snowboarders (34 hips) were included. The mean ± standard deviation age at surgery was 24.5 ± 6.7 years (range, 18.7-46.8 years). A total of 85% (22/26) returned to elite-level competition at 8.9 months (range, 2.9-23.7 months) with an average career length of 3.6 ± 2.7 years after surgery. Four athletes (5 hips) required revision arthroscopy, with adhesions being the most frequent indication. At a mean follow-up of 7.7 ± 3.2 years, significant improvement in PROs (P < .05) was demonstrated for the Hip Outcome Score (HOS)-Activities of Daily Living (from 76 ± 20 to 95 ± 6), HOS-Sport Specific Subscale (from 63 ± 28 to 92 ± 14), modified Harris Hip Score (from 70 ± 19 to 89 ± 12), and 12-Item Short Form Health Survey Physical Component Summary (from 45 ± 11 to 54 ± 8). Patient satisfaction had a mean of 8 ± 2 (range, 1-10) and median of 10. CONCLUSION: The return-to-competition rate in elite skiers and snowboarders after hip arthroscopy for FAI was 85% at an average of 8.9 months and with a career length of 3.6 years after surgery. Significant improvement in PROs was demonstrated for the HOS-Activities of Daily Living, HOS-Sport Specific Subscale, modified Harris Hip Score, and 12-Item Short Form Health Survey Physical Component Summary, with a median patient satisfaction score of 10. These findings support hip arthroscopy as an effective procedure for the treatment of FAI in elite skiers and snowboarders with symptomatic activity-limiting hip pain, allowing them to return to their previous levels of competition at a high rate.

Spatial influence on the distribution of downhill skiers in Sweden.

This study investigates empirically how natural snow depth affects the number of downhill skiers. Data include the number of skier visits for the 32 largest ski resorts in Sweden from the 1998/1999 to the 2018/2019 seasons. Results of spatial dynamic estimations show that an increase in natural snow depth in the ski area has a significant negative impact on the number of skier visits in the short term, although the magnitude is small. This implies that a snow deficit leads to increased demand for downhill skiing both directly and indirectly (in the neighbouring areas). The variable snow depth in the neighbouring ski areas is not significantly different from zero, indicating that no spatial substitution takes place. There is, however, a strong positive relationship between skier visits to neighbouring areas, revealing that ski resorts are complements rather than substitutes. The long-term influence of snow depth is not significant, implying that the ski business is independent of variations in snow depth. Instead, the number of skier visits is mainly determined by past visits, revealing a high degree of persistence.

Race development and performance-determining factors in a mass-start cross-country skiing competition.

Introduction: Although five of six Olympic events in cross-country skiing involve mass-starts, those events are sparsely examined scientifically. Therefore, in this study, we investigated speed profiles, pacing strategies, group dynamics and their performance-determining impact in a cross-country skiing mass-start competition. Methods: Continuous speed and position of 57 male skiers was measured in a six-lap, 21.8 km national mass-start competition in skating style and later followed up with an online questionnaire. Skiers ranked from 1 to 40 were split into four performance-groups: R1-10 for ranks 1 to 10, R11-20 for ranks 11 to 20, R21-30 for ranks 21 to 30, and R31-40 for ranks 31 to 40. Results: All skiers moved together in one large pack for 2.3 km, after which lower-performing skiers gradually lost the leader pack and formed small, dynamic packs. A considerable accordion effect occurred during the first half of the competition that lead to additional decelerations and accelerations and a higher risk of incidents that disadvantaged skiers at the back of the pack. Overall, 31% of the skiers reported incidents, but none were in R1-10. The overall trend was that lap speed decreased after Lap 1 for all skiers and thereafter remained nearly unchanged for R1-10, while it gradually decreased for the lower-performing groups. Skiers in R31-40, R21-30, and R11-20 lost the leader pack during Lap 3, Lap 4, and Lap 5, respectively, and more than 60% of the time-loss relative to the leader pack occurred in the uphill terrain sections. Ultimately, skiers in R1-10 sprinted for the win during the last 1.2 km, in which 2.4 s separated the top five skiers, and a photo finish differentiated first from second place. Overall, a high correlation emerged between starting position and final rank. Conclusions: Our results suggest that (a) an adequate starting position, (b) the ability to avoid incidents and disadvantages from the accordion effect, (c) tolerate fluctuations in intensity, and (d) maintain speed throughout the competition, particularly in uphill terrain, as well as (e) having well-developed final sprint abilities, are key factors determining performance during skating-style mass-start cross-country skiing competitions.

[Comparison of acute sports injury between recreational skiers and skiers].

OBJECTIVE: To compare and analyze the difference between the injuries of recreational skiers in public ski resorts and those of skiing athletes in official competitions, and to explore the suggestions of medical insurance for these two types of skiers. METHODS: The injury data of recreational skiers in Chongli District, Zhangjiakou City, Hebei Province during 2018-2019 and 2019-2020 snow seasons, and the injury data of skiers in two official international skiing competitions during 2019-2020 snow season and domestic test events in Chongli District of 2021 Winter Olympic Games were analyzed retrospectively, and the similarities and differences were compared. RESULTS: A total of 1 187 injuries occurred to recreational skiers in the two public ski resorts during the 2018-2019 snow season, with an injury rate of 0.3%.There were 1 277 injury sites in total, and the most frequent injury sites were head and neck (230 cases, 18.0%), followed by knee joint (204 cases, 16.0%) and lower extremity (131 cases, 10.3%). Thirty-one skiers were injured in the two official international skiing competitions in the 2019-2020 and 2020-2021 snow season, and in the domestic test competitions in the 2021 Winter Olympic Games, and the injury rates were 11.5%, 17.2% and 12.0%, respectively. There were 37 injury sites in total, among which 11 (29.7%) were in the head and neck, followed by 6 (16.2%) in the knee joint and 5 (13.6%) in the chest, rib and abdomen. CONCLUSION: In order to better guarantee the safety of skiers and timely provide corresponding medical help, safety facilities and technical guidance should be added to the snow resort for leisure skiing, and medical stations should be set up in the snow resort. As the formal ski racing for skiing athletes during the game has 30 to 80 times higher injury ratesthan recreational skiers, and compared with the recreational skiing, head and neck injury rate is higher, and the damage is much heavier, more complete first aid facilities and experienced medical workers are, needed so the field should be equipped with the circuit inside the quantities, track fixed outside the clinic, surrounding referral hospitals set up trauma centers to provide athletes with more timely medical care.

An observational study of skier compliance with posted "slow" signs and ski patrollers.

OBJECTIVES: To examine the efficacy of "slow" signs and patroller presence at "slow" signs to reduce speeds of snowsports participants, compared to a condition where no sign or patroller are present, independent of other factors that may contribute to skier slowing (such as prior knowledge, trail convergence, etc.). DESIGN AND METHODS: Snowsports participant speeds were measured on "more difficult" trails using a radar gun at two ski areas with: (1) no-sign - the usual condition for the trail, and (2) slow-sign - a large "slow" sign was posted in the middle of the trail. At one ski area, a third condition was also tested: (3) slow+patroller - a ski patroller stood at the slow sign. Participant equipment type and estimated ability were also recorded. RESULTS: At one ski area, there was no significant difference in speed between conditions. At the second ski area, the differences in mean (SD) speeds were small but significant for the no-sign, slow-sign, and slow+patroller conditions: 10.9 (3.0), 10.3 (2.9), and 9.8 (2.6)m/s. Effects were driven by non-beginner skiers; on average, beginner skiers and all snowboarders were slower than non-beginner skiers and did not adjust their speed in response to the signage conditions. CONCLUSIONS: Reductions in speed for the slow-sign and slow+patroller conditions compared to the no-sign condition were small (0.5 and 1.1m/s) compared to the variation in chosen skier speed reported in other studies. The small differences in chosen speeds make it unlikely that slow sign and patroller presence alone would produce meaningful reductions in collision likelihood or severity of impacts.

Features of Metabolic Support of Physical Performance in Highly Trained Cross-Country Skiers of Different Qualifications during Physical Activity at Maximum Load.

The purpose of our study was to identify the features of metabolic regulation in highly trained cross-country skiers of different qualifications at different stages of the maximum load test. We examined 124 highly trained cross-country skiers (male, ages 17-24). The group consisted of two subgroups based on their competition performance: 61 nonelite athletes (Group I) and 63 elite athletes (group II), who were current members of the national team of the Komi Republic and Russia. The bicycle ergometer test was performed by using the OxyconPro system (Erich Jaeger, Hoechberg, Germany). All the examined athletes performed the exercise test on a cycle ergometer "until exhaustion". The results of our research indicate that the studied groups of athletes with high, but different levels of sports qualifications are a convenient model for studying the molecular mechanisms of adaptation to physical loads of maximum intensity. Athletes of higher qualifications reveal additional adaptive mechanisms of metabolic regulation, which is manifested in the independence of serum lactate indicators under conditions of submaximal and maximum power from maximal oxygen uptake, and they have an NO-dependent mechanism for regulating lactate levels during aerobic exercise, including work at the anaerobic threshold.

Comparison of acute sports injury between recreational skiers and skiers / 北京大学学报(医学版)

OBJECTIVE@#To compare and analyze the difference between the injuries of recreational skiers in public ski resorts and those of skiing athletes in official competitions, and to explore the suggestions of medical insurance for these two types of skiers.@*METHODS@#The injury data of recreational skiers in Chongli District, Zhangjiakou City, Hebei Province during 2018-2019 and 2019-2020 snow seasons, and the injury data of skiers in two official international skiing competitions during 2019-2020 snow season and domestic test events in Chongli District of 2021 Winter Olympic Games were analyzed retrospectively, and the similarities and differences were compared.@*RESULTS@#A total of 1 187 injuries occurred to recreational skiers in the two public ski resorts during the 2018-2019 snow season, with an injury rate of 0.3%.There were 1 277 injury sites in total, and the most frequent injury sites were head and neck (230 cases, 18.0%), followed by knee joint (204 cases, 16.0%) and lower extremity (131 cases, 10.3%). Thirty-one skiers were injured in the two official international skiing competitions in the 2019-2020 and 2020-2021 snow season, and in the domestic test competitions in the 2021 Winter Olympic Games, and the injury rates were 11.5%, 17.2% and 12.0%, respectively. There were 37 injury sites in total, among which 11 (29.7%) were in the head and neck, followed by 6 (16.2%) in the knee joint and 5 (13.6%) in the chest, rib and abdomen.@*CONCLUSION@#In order to better guarantee the safety of skiers and timely provide corresponding medical help, safety facilities and technical guidance should be added to the snow resort for leisure skiing, and medical stations should be set up in the snow resort. As the formal ski racing for skiing athletes during the game has 30 to 80 times higher injury ratesthan recreational skiers, and compared with the recreational skiing, head and neck injury rate is higher, and the damage is much heavier, more complete first aid facilities and experienced medical workers are, needed so the field should be equipped with the circuit inside the quantities, track fixed outside the clinic, surrounding referral hospitals set up trauma centers to provide athletes with more timely medical care.

Thumb Metacarpophalangeal Ulnar and Radial Collateral Ligament Injuries.

Thumb metacarpophalangeal collateral ligament injuries are common in athletes and occur via forced abduction or hyperextension. Management primarily depends on the grade of ligamentous injury and the presence of a Stener lesion or large avulsion fracture. Surgeons should consider the athlete's position, hand dominance, duration of season remaining, and goals. Shared decision making regarding timing of surgery is imperative. Acutely, primary ligamentous repair with or without augmentation is achievable. Chronic collateral ligament injuries are effectively treated with ligament reconstruction. Numerous surgical techniques have been described without 1 showing superiority. Postoperative rehabilitation protocols vary based on repair quality and sports-specific considerations.