Stress fractures—a prospective study amongst recruits

Abstract

BACKGROUNDStress fracture (SF) is the single most common cause for the lost number of manpower days during training of recruits in the Armed Forces. This prospective study was undertaken with a view to develop baseline data on incidence of SF and to identify related variables. METHODA prospective study over a period of five years during [2004][2005][2006][2007][2008][2009] in which a total of 8,570 recruits were enrolled at the start of their training to find out the incidence and pattern of SFs. RESULTSA total of 604 (7.04%, 95% CI 6.40-7.40%) out of a total of 8,570 recruits sustained SF during the study period. The majority of fractures occurred during basic training. The factors like urban residence, vegetarianism and those without prior history of physical activity were found to be associated with SF. Tibia was the commonest bone involved. CONCLUSIONPrevention is undoubtedly the best approach in SF and other sports injuries. Priority should be given to individuals with good sports and physical activity background during recruitment. Intensity of training should be gradually increased during first three months (12 weeks) of training.

High Incidence of Stress Fractures in Military Cadets During Training: A Point of Concern

“…However, in India two studies by Agrawal PK and Dash N et al, reported high incidence of 11.4% and 7.04% in two different military training centres [4,6]. Apparently, the 15% incidence of SFs in our study far exceeds this figure or those reported from any previous study.…”

“…An additional bone scan was not performed in cases where radiographs were inconclusive as reported by Agrawal PK in his study [6]. It is thus likely that the incidence, we reported, could have been even higher if a bone scan or an additional scintigraphy was performed.…”

Veganism, vegetarianism, bone mineral density, and fracture risk: a systematic review and meta-analysis

“…[24][25][26][27][28][29][30][31][32][33][34][35][36][37][38] Number of fractures and body site of the fracture were also recorded (Table 3). 19,20,[39][40][41] Bone mineral density values were extracted from the different studies, and only raw data (unadjusted) were used to perform the meta-analyses. Dual-energy X-ray absorptiometry enables different types of scans that give information on several regions.…”

“…The 20 studies included 37 134 individuals (BMD data were available for 4003 individuals, and fracture rate data were available for 33 131 individuals). 19,20,[24][25][26][27][28][29][30][31][32][33][34][35][36][37][38][39][40][41] The mean age of the participants varied from 25 to 80 years, and most of the studies equally sampled omnivores and vegetarians/vegans. One study only included men (5%; n ¼ 1/20), most of the studies (65%; n ¼ 13/20) only included women, and 6 studies included both women and men (30%; n ¼ /20).…”

“…Subgroup analyses by age, years of follow-up, and study quality were not possible because only 2 studies included the age of the participants, 19,20 only 1 included a long-term follow-up (>10 y), 39 and only 1 was determined to be of low quality (score of <50 points). 40 Sensitivity analysis. A sensitivity analysis was developed excluding the Appleby et al study 19 as a possible outlier (see Figure 5).…”