Bone Stress Injuries in the Military: Diagnosis, Management, and Prevention

Steven F. DeFroda, Kenneth L. Cameron, Matthew Posner, Peter K. Kriz, Brett D. Owens

Research output: Contribution to journalReview articlepeer-review

12 Scopus citations

Abstract

Bone stress injuries occur when forces applied to a bone for an extended period exceed the ability of the bone to adequately remodel. These injuries, which range from stress reactions to nondisplaced and even displaced fractures, most often affect people who experience high levels of repetitive stress and loading in the lower extremity or changes in physical activity level. For example, stress fractures are common in endurance athletes, in athletes engaged in preseason and early-season conditioning, and in military recruits. In the military, these injuries are most often encountered during basic training, when new recruits undergo the rigors of intense physical activity to which they may not be accustomed. Female athletes and athletes with poor nutritional status are at elevated risk for injury. Bone stress injuries are difficult to diagnose with radiographs alone. Making the correct diagnosis may require a combination of physical examination, advanced imaging, and an index of suspicion. Differences in injury location account for variations in risk for nonunion, displacement, and other complications. For low-risk injuries, treatment typically consists of reduced weight-bearing for several weeks with gradual return to activity. Higher-risk injuries need to be closely monitored for progression and may require operative intervention. Even after surgery, some types of stress fractures may take several months to achieve radiographic union. In addition, underlying nutritional or metabolic deficiencies may need to be treated to prevent future injuries. In this article, we review the diagnosis, management, and prevention of bone stress injuries with a focus on more serious manifestations, such as stress fracture.

Original languageEnglish (US)
Pages (from-to)176-183
Number of pages8
JournalAmerican journal of orthopedics (Belle Mead, N.J.)
Volume46
Issue number4
StatePublished - Jul 1 2017

All Science Journal Classification (ASJC) codes

  • General Medicine

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