Incidence of Stress Fractures in Indian Military Recruits

Abstract

Introduction: Stress fractures are common in Military recruits during their training period and give rise to morbidity and loss of training hours. Some cadets with stress fractures are re-instated while some are expelled out of service resulting in attrition and economic loss. Aim: A study to find out the incidence of stress fracture in Border Security force (BSF) military recruits in India. Method: A prospective analysis of stress fractures among 2000 BSF cadets was done in a period of 9 months of their training. Recruits with metabolic abnormality were excluded. Clinical and radiological diagnosis was made and was followed up every 4 weeks till the time of union. Result: The incidence of stress fractures among BSF trainees was found to be 15%. The incidence of stress fractures was highest during their initial weeks of physical training exercises and reached maximum at 12 weeks of the training schedule. 263 tibia, 24 fibula, 6 metatarsal, 5 femur shaft and 2 femoral neck stress fracture were seen. 3 tibia, 3 femur and 1 neck of femur fractures were operated and the rest were treated conservatively. All the fractures healed uneventfully. Conclusion: Stress fractures are due to sudden increase in the amount and intensity of physical activity along with repeated forces due to running on a hard surface, improper training protocol, equipment. Higher incidence of stress fracture (15%) in our study suggests an appraisal and modification in training programme of military recruits.