Kupferer Kevin R, Bush David M, Cornell John E, Lawrence Valerie A, Alexander Jeffrey L, Ramos Rosemarie G, Curtis Denice
Air Force Medical Support Agency/SG5I, 7700 Arlington Boulevard, Falls Church, VA 22042-5164.
University of Texas Health Science Center, San Antonio, IIMS/Research C-TREO - MC 7757, 7703 Floyd Curl Drive, San Antonio, TX 78229-3900.
Mil Med. 2014 Jan;179(1):56-61. doi: 10.7205/MILMED-D-13-00154.
Stress fractures are a common overuse problem among military trainees resulting in preventable morbidity, prolonged training, and long-term disability following military service. Femoral neck stress fractures (FNSFs) account for 2% of all stress fractures but result in disproportionate burden in terms of cost and convalescence. The purpose of this study was to describe and investigate FNSF in U.S. Air Force basic trainees and to present new data on risks factors for developing FNSF. We examined 47 cases of FNSF occurring in Air Force basic trainees between 2008 and 2011 and 94 controls using a matched case-control model. Analysis with t tests and conditional logistic regression found the risk of FNSF was not associated with body mass index or abdominal circumference. Female gender (p < 0.001) and slower run time significantly increased risk of FNSF (1.49 OR, p < 0.001; 95% CI 1.19-1.86). A greater number of push-up and sit-up repetitions significantly reduced risk of FNSF (0.55 OR, p = 0.03; 95% CI 0.32-0.93; 0.62 OR, p = 0.04; 95% CI 0.4-0.98) for females. In this study body mass index was not correlated with FNSF risk; however, physical fitness level on arrival to training and female gender were significantly associated with risk of FNSF.
应力性骨折是军事训练学员中常见的过度使用损伤问题，会导致可预防的发病情况、训练时间延长以及服役后的长期残疾。股骨颈应力性骨折（FNSF）占所有应力性骨折的2%，但在成本和康复方面造成了不成比例的负担。本研究的目的是描述和调查美国空军基础训练学员中的股骨颈应力性骨折，并提供有关发生股骨颈应力性骨折风险因素的新数据。我们使用匹配病例对照模型，检查了2008年至2011年期间发生在空军基础训练学员中的47例股骨颈应力性骨折病例和94名对照。通过t检验和条件逻辑回归分析发现，股骨颈应力性骨折的风险与体重指数或腹围无关。女性（p < 0.001）和较慢的跑步时间显著增加了股骨颈应力性骨折的风险（比值比1.49，p < 0.001；95%置信区间1.19 - 1.86）。更多的俯卧撑和仰卧起坐重复次数显著降低了女性股骨颈应力性骨折的风险（比值比0.55，p = 0.03；95%置信区间0.32 - 0.93；比值比0.62，p = 0.04；95%置信区间0.4 - 0.98）。在本研究中，体重指数与股骨颈应力性骨折风险无关；然而，训练开始时的身体素质水平和女性性别与股骨颈应力性骨折风险显著相关。
