International Journal of Contemporary Surgery. January-June., 2014, Vol.2, No. 1 89 DOI Number: 10.5958/j.2321-1024.1.2.018 A Retrospective Study of Stress Fractures During Training Rajendra Harnagle 1 , P S Chawla 2 , Khyati Kalra 3 1 Professor & Hod, Community Medicine, Azeezia Institute of Medical Sceinces & Research, Meeyanoor P.O., Kollam District,Kerala, 2 Professor, 3 Assistant Professor Cum Statistician, Dept of Community Medicine, Smt. Kashibai Navale Medical College and General Hospital, Pune ABSTRACT A retrospective analysis of data for a period of five years was carried out to study the pattern of stress fractures amongst military recruits in three regimental centers (Two Infantry regimental centers and one of Signal) located in a large military station located in central India. The maximum of stress fractures occurs at 19th year of age. The Infantry recruits were significantly more affected. Muslim recruits were more affected which was statistically significant. Most stress fractures occurred within 6 months of training. Cases of fracture tibia were most common. Fracture femur was the second common site. Keywords: Stress Fracture, Military Recruits.Severe Training, Retrospective Analysis Fracture Tibia INTRODUCTION A stress fracture is one type of incomplete fracture in bones. It is caused by “unusual or repeated stress” and also heavy continuous weight on the ankle or leg. [1] This is in contrast to other types of fractures, which are usually characterized by a solitary, severe impact Stress fractures commonly occur in sedentary people who suddenly undertake a burst of exercise (whose bones are not used to the task). Bones are constantly attempting to remodel and repair themselves, especially during a sport where extraordinary stress is applied to the bone. Over time, if enough stress is placed on the bone that it exhausts the capacity of the bone to remodel, a weakened site— a stress fracture—on the bone may appear. The fracture does not appear suddenly. It occurs from repeated traumas, none of which is sufficient to cause a sudden break, but which, when added together, overwhelm the osteoblasts that remodel the bone. Muscle fatigue can also play a role in the occurrence of stress fractures. In a runner, each stride normally exerts large forces at various points in the legs. Each shock—a rapid acceleration and energy transfer—must be absorbed. Both muscles and bones serve as shock absorbers. However, the muscles, usually those in the lower leg, become fatigued after running a long distance and lose their ability to absorb shock. As the bones now experience larger stresses, this increases the risk of fracture. A stress fracture is best diagnosed after interview and examination by a physician. Investigations are not necessary to diagnose a stress fracture. X-rays usually do not show any evidence of stress fractures, so a CT scan, MRI, or 3-phase bone scan may be more effective in unclear cases. Stress fractures are of interest to the military since there are high rates of stress fractures during basic training of recruits, resulting in a substantial loss of training time. Dr Johnathan C Reeser states that, in the US, the annual incidence of stress fractures in athletes and military recruits ranges from 5% to 30%, depending on the sport and other risk factors. [2] Despite the importance of stress fracture in the Army, particularly during the basic training, very few studies have carried out to study the epidemiology of this condition in the Military settings. With this background, the present study was undertaken with the objectives of studying the frequency of this condition in the regimental centers and it’s association with various demographic and training factors.