Determinants of stress fracture risk in United States Military Academy cadets

Felicia Cosman*, Jamie Ruffing, Marsha Zion, John Uhorchak, Stuart Ralston, Susan Tendy, Fiona E. A. McGuigan, Robert Lindsay, Jeri Nieves

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Prior studies have identified some risk factors for stress fracture in athletes and military recruits.

Objective: To determine whether historical factors, physical measures, biochemical variables of skeletal metabolism, genetic factors, bone density (BMD) and bone size could predict risk of stress fracture over 4 years in physically fit cadets at the US Military Academy (USMA).

Methods: Baseline surveys, assessments of height, weight, scores on the Army Physical Fitness Test, and peripheral BMD were obtained in all cadets (755 men, 136 women), and central BMD in a subset. Blood samples were analyzed for variables of calcium homeostasis, bone turnover, and selected hormones and genetic factors. Stress fractures were adjudicated by review of orthopedic notes and imaging reports.

Results: 5.7% of male and 19.1% of female cadets had at least 1 stress fracture (58% metatarsal and 29% tibial), most within 3 months of entry to USMA. In males, risk of stress fracture was higher in those who exercised

Conclusion: Although prior physical training in men, length of prior estrogen exposure in women and leg bone dimensions in both genders played a role, the maximum variance explained by all of these factors was below 10%. We conclude these factors play a minor role in the development of stress fractures in physically fit USMA cadets. (C) 2013 Elsevier Inc. All rights reserved.

Original languageEnglish
Pages (from-to)359-366
Number of pages8
JournalBone
Volume55
Issue number2
DOIs
Publication statusPublished - Aug 2013

Keywords

  • Stress fractures
  • Insufficiency fractures
  • Military
  • Department of Defense
  • Athlete
  • FEMALE NAVY RECRUITS
  • BONE-DENSITY
  • QUANTITATIVE ULTRASOUND
  • CALCIUM INTAKE
  • ARMY RECRUITS
  • INJURY RATES
  • YOUNG MEN
  • WOMEN
  • GENDER
  • SUSCEPTIBILITY

Fingerprint

Dive into the research topics of 'Determinants of stress fracture risk in United States Military Academy cadets'. Together they form a unique fingerprint.

Cite this