Prevalence of stress fracture in military cadets

Author(s): Dr. Arjun Jain, Dr. Daksh Sharma, Dr. Ravikant Jain, Dr. Vishal Champawat, Dr. Yogesh Patel and Dr. Abhishek Jain

Abstract: Introduction: Stress fractures have continued to plague competitive athletes and military recruits, especially at the beginning of military service. The underlying pathophysiology of stress fractures occurs when the rate of repetitive microtrauma exceeds that of osseous remodeling. The prevention of lower extremity stress fractures remains a long-standing problem in the military, and it represents a significant socioeconomic burden. Treatment strategies include early identification of the symptoms, early diagnosis, a sufficiently long training pause. The present study aimed at determining the incidence and type of Stress Fractures in Border Security Force cadets (BSF) recruited in Indore through clinical and radiological diagnosis.
Material and Methods: In a prospective study of Stress Fractures, a group of 1000 BSF cadets training in Indore was selected and those presenting with symptoms were evaluated clinically and radiologically. The SF was graded in to 4 groups based on the suggested clinicoradiological classification by Agarwal.
Results: One hundred and seventy four (174) out of 1000 consecutive recruits had symptoms of SFs. Out of 150 diagnosed with SF 60 (40%) were Grade I, 54 (36%) was Grade II, 29 (19.33%) were Grade III and 7 (4.67%) were Grade IV. The significant higher incidence of SFs has been attributed to training with maximum stress on running, jumping, parade on hard ground, and gymnastics. The maximum occurrence of Stress fracture in our study was found at 10 weeks of training.
Conclusion: There is a high incidence of SF in military cadets which tends to remain unreported otherwise. Proper education of trainees, trainers and instructors, modification in training procedures, use of better equipments can reduce occurrence of these fractures. Early reporting to hospital and treatment is also necessary as it can help in early return to full activity.

DOI: https://doi.org/10.22271/ortho.2018.v4.i2f.59