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Jonas Krueckel,1 Dominik Szymski,1 Julia Lenz,1 Julian Fluegel,2 Johannes Weber,1 Leonard Achenbach,3 Rainer Meffert,4 Volker Alt,1 Kai Fehske4,5 1Department of Trauma Surgery, University Medical Center Regensburg, Regensburg, Germany; 2Department of Orthopaedic Surgery, Arcus Clinics Pforzheim, Pforzheim, Germany; 3Department of Orthopaedic Surgery, Koenig Ludwig Haus Wuerzburg, Wuerzburg, Germany; 4Department of Trauma Surgery, University Hosptial Wuerzburg, Wuerzburg, Germany; 5Department of Orthopedic and Trauma Surgery, Johanniter Waldkrankenhaus Bonn, Bonn, GermanyCorrespondence: Kai Fehske, Department of Orthopedic and Trauma Surgery, Johanniter Waldkrankenhaus Bonn, Waldstraße 73, Bonn, 53177, Germany, Email Fehske_k@ukw.de Jonas Krueckel, Department of Trauma Surgery, University Medical Center Regensburg, Regensburg, Germany, Email jonas.krueckel@ukr.dePurpose: While injuries among elite tennis athletes are extensively documented, a notable research gap exists regarding tennis injuries among club-level players. This study examines tennis injuries in German league players, with a particular emphasis on the impact of racquet properties and court surfaces, distinguishing between chronic and acute injuries.Patients and Methods: Retrospectively analyzing data from 600 tennis players over a 1.5-year period, a standardized questionnaire covered anthropometrics, injury characteristics, equipment usage, and court surface conditions.Results: The study identified 1012 tennis-related injuries, averaging 1.7 per player. Acute injuries predominantly affected the lower extremity (56%), with ankle injuries being the most prevalent, and ligaments were the most commonly affected structures (36.4%). Chronic complaints (reported by 364 athletes) focused on the upper extremity (63.2%), primarily tendon injuries (56.8%). Racket properties exhibited no significant impact on chronic upper extremity injuries.Conclusion: This study highlights a high incidence of acute lower extremity injuries, especially ankle ligament injuries, among German league tennis players. It offers crucial insights for devising targeted injury prevention strategies applicable to amateur, semi-professional, and professional tennis players, despite finding no significant link between racquet material and chronic upper extremity injuries.Keywords: tennis, injury, epidemiology, court surface, racquet material, ankle, ligament

Dominik Szymski,1 Leonard Achenbach,2,3 Martin Siebentritt,4 Karola Simoni,5 Norbert Kuner,5 Christian Pfeifer,1 Werner Krutsch,1,6 Volker Alt,1 Rainer Meffert,2 Kai Fehske2 1Department of Trauma Surgery, University Medical Centre Regensburg, Regensburg, Germany; 2Department of Trauma-, Hand-, Plastic- and Reconstructive Surgery, University Wuerzburg, Wuerzburg, Germany; 3Department of Orthopaedics, Koenig-Ludwig-Haus, University Wuerzburg, Wuerzburg, Germany; 4Department for Anesthesiology and Operative Intensive Care, Bayreuth, Germany; 5General Medicine and Dermatology, Medical Center for General Medicine, Dermatology, Paediatrics and Internal Medicine, Costa Calma Fuerteventura, Costa Calma, Spain; 6Sports-Orthopedics, SportDocs Franken, Nuremberg, GermanyCorrespondence: Kai FehskeDepartment of Trauma-, Hand-, Plastic- and Reconstructive Surgery, University Wuerzburg, Wuerzburg, GermanyTel +49 931 201 37001Fax +49 931 201 37009Email kai.fehske@ukw.deIntroduction/Background: Surfing, wind surfing and kite surfing enjoy a growing popularity with a large number of athletes worldwide. The aim of this study was to identify and compare the injury profiles and compare the injury profiles of these three extreme water sports.Materials and Methods: These data for this retrospective cohort study were collected through an online standardised questionnaire during the 2017– 18 season. The questionnaire included questions about anthropometry, skill level, injury diagnosis, injury mechanism, environmental conditions and training regimes.Results: The 626 athletes included reported 2584 injuries. On average, each athlete sustained 4.12 injuries during the season. The most frequent injury location was in the lower extremity, in particular the foot, with 49 (16.4%) injuries in surfing, 344 (18.3%) in wind surfing and 79 (19.7%) in kite surfing. Surfing demonstrated a particularly high rate of head injuries (n = 37; 12.4%). Other frequent injury types were skin lesions (up to 42.1%) and contusions (up to 40.5%). The most common injury across all surfing sports was skin lesions of the foot (wind surfing: 11.7%; kite surfing: 13.2%; surfing: 12.7%). In surfing, skin lesions of the head were frequently observed (n = 24; 8.0%). In surfing, a ‘too large wave’ (n = 18; 24.7%) was main cause of the injury, while in wind surfing (n = 189; 34.5%) and kite surfing (n = 65; 36.7%) ‘own incompetence’ led to the most injuries.Conclusion: This unique study compares injury epidemiology and mechanism in the three most popular surfing sports: wind surfing, kite surfing and surfing. Overall, injuries were sustained mainly in the lower extremity, while surfing also demonstrated a high rate of head injuries.Keywords: water sports, injury, training, ankle, foot, epidemiology

Volker Krutsch,1 Annabelle Clement,2 Tobias Heising,3 Leonard Achenbach,4 Christian Pfeifer,2 Johannes Weber,2 Volker Alt,2 Werner Krutsch2,5 1Department of Otorhinolaryngology, Paracelsus Medical University Nuremberg, Nuremberg, Germany; 2Department of Trauma Surgery, University Medical Centre Regensburg, Regensburg, Germany; 3Department of Internal Medicine, Marienhospital Osnabrueck, Osnabrueck, Germany; 4Department of Trauma Surgery, University Hospital Wuerzburg, Wuerzburg, Germany; 5SportDocsFranken, Nuremberg, GermanyCorrespondence: Werner KrutschDepartment of Trauma Surgery, University Medical Centre Regensburg, Franz-Josef-Strauß Allee 1, Regensburg 93053, GermanyTel +49 176 24225995Email werner.krutsch@ukr.dePurpose: Small-field soccer is a popular type of amateur sports worldwide. One type of small-field soccer growing in popularity is bubble-soccer, but injury risks and injury patterns are still unclear. This study investigates the factors influencing injuries in bubble-soccer for the first time.Materials and Methods: This prospective cohort study of an outdoor tournament investigated the injury incidence and injury patterns as well as the factors influencing injuries in bubble-soccer matches. Data were collected according to the statement on data collection and injury definition. Preparation and physical outcome were assessed for both sexes.Results: Of 145 players (104 men, 41 women), 58 players sustained 94 injuries during the tournament and 64% of injuries affected the lower extremities. The most common traumatic injuries were skin lesions (37.5%), acute pain (15.6%) and contusion (7.8%). More female players (3818.2/1000 h bubble-soccer) than male players (1474.4) were affected by injury, mostly to the knees or the head. Also, women significantly more often reported neck pain than men (p< 0.042); 29.0% of players felt uncomfortable wearing the bubble, and 21.4% reported neurological symptoms such as headache or dizziness after the match.Conclusion: Bubble-soccer shows a relatively high injury incidence. Women had a higher injury incidence and were more often affected by traumatic injuries to the head and neck including feeling of discomfort and headache or neck pain after the match. Adequate preparation seems to be essential for injury prevention, and players should recognise the high injury risk of bubble-soccer.Keywords: bubble soccer, injury, soccer, risk factor, prevention

Volker Krutsch,1 Stephan Grechenig,2 Oliver Loose,3 Leonard Achenbach,4 Johannes Zellner,2 Heiko Striegel,5 Volker Alt,2 Johannes Weber,2 Markus Braun,6 Stephan Gerling,7 Werner Krutsch2 1Department of Otorhinolaryngology, Head and Neck Surgery, Paracelsus Medical University, General Hospital Nuremberg, Nuremberg, Germany; 2Department of Trauma Surgery, University Medical Center Regensburg, Regensburg, Germany; 3Clinic of Pediatric Surgery, Olga Hospital, Clinic Stuttgart, Stuttgart, Germany; 4Department of Trauma Surgery, University Hospital Würzburg, Würzburg, Germany; 5Department of Sports Medicine, University Hospital Tuebingen, Tuebingen, Germany; 6Department of Sports Medicine, Clinic Westfalen, Dortmund, Germany; 7Department of Paediatric and Young Adult Medicine, Clinic St. Hedwig, Barmherzige Brüder Regensburg, Regensburg, GermanyCorrespondence: Werner KrutschDepartment of Trauma Surgery, University Medical Center Regensburg, Franz-Josef-Strauß-Allee 11, Regensburg 93053, GermanyTel +49 941 9446805Email werner.krutsch@ukr.dePurpose: Injury data of professional soccer players obtained from media reports are frequently used in scientific research, but the accuracy of such data is still unclear.Patients and Methods: Injuries of professional soccer players of the German first and second league were documented by continuously screening media reports over one season (2015– 2016). After the season, the validity of media-reported injuries was anonymously analyzed by the team physicians of 8 different soccer clubs.Results: A total of 255 injuries of 240 players of 8 professional soccer teams had been published online, of which 146 were confirmed by the team doctors as correct, yielding a rate of 57.3% of confirmed media-reported injuries. In addition, 92 injuries without media registration were detected and added to the online statistics, resulting in 347 injuries and an overall weak validity of media-based data of 42.1%. Statistical analysis showed that the validity of media-reported injury data depended on both the individual soccer club and the body site affected by injury: publications on knee injuries (78.2%) had a higher validity than those on foot injuries (46.2%), and publications on severe injuries had a higher validity (joint dislocation: 100%; ligament rupture: 82.9%; fracture: 73.3%) than those on minor injuries. Publications on specific severe soccer injuries, such as anterior cruciate ligament (ACL) injuries, had a validity of 100%.Conclusion: Media-based injury data were only valid for a few severe injury types such as ACL injuries. In daily soccer routine and scientific research, media-based data should thus only be used in combination with specific criteria or verification processes.Keywords: professional football, injury, evidence, media-based, severe injury, ACL