Neuromuscular and inflammatory responses to handball small-sided games: the effects of physical contact.

The aim of this study was to investigate the influence of physical contact on neuromuscular impairments and inflammatory response during handball small-sided games. Using a counterbalanced design, 12 elite male junior handball players were divided into two groups: contact (C-SSG) and no-contact (NC-SSG), performing both contact and no-contact small-sided games, in reverse order on two training sessions separated by 5 days. The methodology and rules were identical for the two SSG regimens, with the only difference being the inclusion or prohibition of upper body use for physical contacts. Upper and lower body neuromuscular performances and blood concentrations of inflammatory cytokine IL-6 were assessed before and immediately after the games. During small-sided games, video analysis was used to establish the physical contact counts. Significant differences were found in most upper and lower limbs muscles kinetic variables and in the physical contact events (all P < 0.001) following the two training regimens. There was an increase in IL-6 after C-SSG and no changes following NC-SSG (P < 0.05 and P = 0.12, respectively). Moreover, a strong correlation was found between the number of physical contacts and IL-6 responses (r = 0.971, P < 0.001) in C-SSG. This study indicates that an inflammatory response and large upper and lower body neuromuscular impairments result from physical contact in elite handball players. These outcomes outline the specific physiological profile of C-SSG that, in turn, might be used by practitioners and coaches as a practical approach to strategically select exercises in athlete's overall training program.

Closed reduction and internal fixation for intertrochanteric femoral fractures is safer and more efficient using two fluoroscopes simultaneously.

The purpose of the study was to assess whether using two fluoroscopes simultaneously in closed reduction and internal fixation of a stable intertrochanteric fracture reduces radiation and operation time. Patients who sustained a stable intertrochanteric femoral fracture were operated in our institution with closed reduction and internal fixation. They were randomly allocated to be operated with the assistance of one or two fluoroscopes. With one device, the radiology technician controlled and moved it to the desired anterior-posterior or axial view. With two fluoroscopes, one was positioned in the anterior-posterior view and the other in the axial view, both controlled by the surgeon. Total radiation and operation time were collected for all patients and compared between the two groups. A total of 27 patients participated in the study. One fluoroscope was used for 13 surgeries and two in 14. Total radiation time was shorter with two fluoroscopes compared to the use of one (36.6±8.6s versus 51.2±18.9s, respectively; p<0.02), as was total operation time (24.3±4.2min and 34.7±11.9min, respectively; p<0.01). Working simultaneously with two fluoroscopic devices is safer for the medical team in the operating theatre, because it decreases the patient's radiation exposure, wound exposure time, and anaesthesia time. It saves operating room time and fluoroscopy personnel during the operation. When operating on hip fractures that are planned to be reduced and fixated, we recommend working with two fluoroscopes simultaneously.