US Army Public Health Center, Epidemiology and Disease Surveillance, Aberdeen Proving Ground, Maryland, USA
US Army Public Health Center, Epidemiology and Disease Surveillance, Aberdeen Proving Ground, Maryland, USA.
BMJ Mil Health. 2022 Aug;168(4):286-291. doi: 10.1136/bmjmilitary-2020-001648. Epub 2021 Feb 5.
Multiple studies report increasing cases of surgically treated pectoralis major (PM) muscle and tendon ruptures in military populations. Studies associate this with a growing popularity of weight-training and bench press exercises. Mild-to-moderate non-surgical PM traumas and overuse injuries have not been included in these studies despite evidence that these types of outpatient injuries account for the majority of the military's injury medical burden.
To assess rates of all PM injuries (ruptures, tears, strains, overuse), regardless of form of treatment, a PM injury surveillance definition was derived from International Classification of Disease (ICD) diagnostic codes used in routine US Army injury surveillance. A detailed clinical examination of 2016 Active Duty Army medical records was used to identify ICD codes commonly associated with PM injuries. Cost data were calculated and the definition applied to medical data from 2016 through 2018to assess trends.
The estimated incidence of PM cases among soldiers was over 95% greater than if only considering severe surgical cases. Over 96% of army annual PM injury costs (direct medical and indirect from lost labour) were for outpatient services. PM injury incidence rates were not statistically different from 2016 to 2018.
The PM injury surveillance definition provides a consistent means to monitor trends over time and evaluate the effectiveness of prevention efforts. PM injuries have a larger military impact than previously recognised and prioritised prevention strategies are needed to reduce them. Future interventions could focus on the bench press given its observed association with PM injuries.
多项研究报告称，军事人群中接受手术治疗的胸大肌（PM）肌肉和肌腱断裂的病例不断增加。这些研究将其与举重和卧推练习的日益普及联系起来。尽管有证据表明，这些类型的门诊损伤占军队伤病医疗负担的大部分，但这些研究并未包括轻度至中度的非手术 PM 创伤和过度使用损伤。
为了评估所有 PM 损伤（破裂、撕裂、拉伤、过度使用）的发生率，无论治疗形式如何，都从国际疾病分类（ICD）诊断代码中得出了 PM 损伤监测定义，这些代码用于常规的美国陆军损伤监测。对 2016 年现役军人的医疗记录进行了详细的临床检查，以确定与 PM 损伤相关的常见 ICD 代码。计算了成本数据，并将该定义应用于 2016 年至 2018 年的医疗数据，以评估趋势。
与仅考虑严重手术病例相比，士兵中 PM 病例的估计发生率高出 95%以上。超过 96%的陆军年度 PM 伤病直接医疗费用和间接因劳动力损失的费用都用于门诊服务。PM 损伤发生率在 2016 年至 2018 年之间没有统计学差异。
PM 损伤监测定义提供了一种一致的方法来监测随时间的趋势，并评估预防工作的效果。PM 损伤对军队的影响比之前认识到的要大，需要优先制定预防策略来减少它们。未来的干预措施可以集中在卧推上，因为它与 PM 损伤有关。
