Study of stress fracture contributing factors and its association with bone mineral density in recruit trainee in one of the training center of Central India

Abstract

Background: Stress fracture represents the inability of the skeleton to withstand repetitive bouts of mechanical loading, which results in structural fatigue and resultant signs and symptoms of localized pain and tenderness. There are various factors of stress fracture such as training error, over training, and anatomical factors. This study was aimed to understand the contributing factors of stress fracture in military recruits and its association with bone mineral density. Objectives: This study is aimed to evaluate: (1) various factors contributing to the development of stress fractures and (2) association of bone mineral density and the incidence of stress fractures. Materials and Methods: The study was conducted in 580 recruits at one of the paramilitary training centers of central India for 2 years. Diagnosis of stress fracture was made by careful history and physical examination. Bone mineral density is measured and data were analyzed and evaluated by standard statistical methods. Results: In maximum number of cases, the precipitating cause was running (in 44% cases). FPET was responsible for a large number of cases (38%). No association was established between the calcaneal bone mineral density level and the occurrence of stress fractures. The recruits who were using good-quality sport shoes showed least incidences of stress fracture and who were using PT shoes showed the highest incidences. Conclusion: It can be concluded that to reduce the morbidity in trainees, the proper care of type of shoes can reduce the incidence of stress fracture. Proper rest time between the training sessions can also improve the condition. More sensitive modalities can be used to diagnose the case at an early intervention period. However, more studies are required to elaborate the contributing factors.