Bhatnagar Abhinav, Kumar Manoj, Shivanna Deepak, Bahubali Aski, Manjunath Dayanand
Registrar, Department of Orthopaedics, Fortis hospital , Mumbai, India .
Professor, Department of Orthopaedics, Bangalore Medical College and Research Institute , Bangalore, India .
J Clin Diagn Res. 2015 Aug;9(8):RC01-3. doi: 10.7860/JCDR/2015/12535.6282. Epub 2015 Aug 1.
Stress fractures occur due to repetitive cumulative micro trauma on the bone over a period of time. Stress fractures in military cadets is a rising cause of concern. It increases morbidity, long periods of absence from training and economic losses.
The purpose of this prospective study was to determine the incidence and distribution of stress fracture (SFs) in Border Security Forces (BSF) cadets in Bangalore during their basic training tenure.
A detailed analysis of history and physical assessment was performed of those presenting with symptoms of pain, swelling or deformity. These cadets then underwent radiographic imaging for the evaluation of symptoms. All cadets with clinical and radiological diagnosis of SFs were appropriately managed and followed up every two weeks till the time of union.
Three hundred BSF candidates had clinical and radiological signs of SF with an overall incidence rate of 15%. The average age of the patients with SFs was 23 years (range 20-26). The incidence of SFs was highest during their physical training exercises and reached maximum at 12 weeks of the training schedule. Overall, the most common sites of bone injuries were the tibia (87.66%), fibula (7.8%), and metatarsals (2%). There were 5 femur fractures including one bilateral femur(1.67%) and two neck of femur (0.67%). Three tibia, three femur shaft and two neck femur fractures were operated and rest treated conservatively. All fractures healed in an average period of seven weeks. All cadets returned to their full activity in an average period of nine weeks.
The study provides evidence that SF among BSF cadets occur frequently during their training period with undoubtedly high incidence rate which is probably underrated in Indian setting. To prevent stress fractures, modifiable causes and risk factors must be identified and a proactive approach which can help the cadets withstand intense physical activity should be adopted.
应力性骨折是由于一段时间内骨骼反复受到累积性微创伤而发生的。军事学员中的应力性骨折是一个日益引起关注的原因。它会增加发病率、导致长时间无法参加训练以及造成经济损失。
这项前瞻性研究的目的是确定班加罗尔边境安全部队（BSF）学员在基础训练期间应力性骨折（SFs）的发病率和分布情况。
对出现疼痛、肿胀或畸形症状的人员进行详细的病史分析和体格检查。这些学员随后接受影像学检查以评估症状。所有经临床和放射学诊断为应力性骨折的学员都得到了适当的治疗，并每两周随访一次直至骨折愈合。
300名BSF学员有应力性骨折的临床和放射学体征，总体发病率为15%。应力性骨折患者的平均年龄为23岁（范围20 - 26岁）。应力性骨折的发病率在体能训练期间最高，在训练计划的第12周达到峰值。总体而言，最常见的骨损伤部位是胫骨（87.66%）、腓骨（7.8%）和跖骨（2%）。有5例股骨骨折，包括1例双侧股骨骨折（1.67%）和2例股骨颈骨折（0.67%）。3例胫骨骨折、3例股骨干骨折和2例股骨颈骨折接受了手术治疗，其余采用保守治疗。所有骨折平均在7周内愈合。所有学员平均在9周后恢复到完全活动状态。
该研究提供的证据表明，BSF学员在训练期间应力性骨折频繁发生，发病率无疑很高，在印度这种情况可能被低估了。为预防应力性骨折，必须识别可改变的病因和危险因素，并应采取积极措施帮助学员承受高强度的体育活动。
