12555 Stress Fractures In A Military Population Across Different Career Stages

Abstract Disclosure: A.J. Spiro: None. M.K. Shakir: None. T.D. Hoang: None. Stress fractures are overuse injuries that occur in people with normal bones in the absence of an acute injury. They tend to occur in individuals who are beginning new or more intense physical activity and affect military personnel at higher rates than the general population. These injuries negatively impact force readiness and may lead to serious injury or discharge from military service. Much of the existing literature has focused on basic training recruits, as this population is known to be susceptible to stress fractures. Few studies have examined military populations with many years of service to evaluate how fracture trends may change after the initial basic-training period. We aimed to characterize stress fracture patterns in military personnel over the full spectrum of career stages, from new recruit through late career, and identify whether stress fracture locations varied by career length. We performed a retrospective chart of review covering a 3-year period (from Jan 1, 2017 to Dec 31, 2019) of military patients in the National Capital Region who were diagnosed with a new stress fracture. Career length was defined at the time of diagnosis as: new recruit (<12 months’ time-in-service), early-career (1 to <5 years’ time-in-service), mid-career (5 to <14 years’ time-in-service), and late-career (≥14 years’ time-in-service). Stress fracture locations were defined as: tibia, fibula, foot, femoral neck, femoral shaft, and pelvis. Frequencies of fracture types and presence of multiple fractures were described and compared by career length group using Chi-square tests. Femoral neck (11.1% vs 3.6%), femoral shaft (8.1% vs 1.8%), and pelvis fractures (3.8% vs 0.7%) were more frequent in new recruits vs other career length groups (p≤0.03 for each). Foot fractures were less frequent (19.2% vs 34.3%) in new recruits vs other career length groups (p<0.001). The presence of multiple fractures (23.7% vs 10.1%) was more frequent in new recruits vs others (p=0.01). Frequencies of each fracture type and of presence of multiple fractures were qualitatively similar among early-career, mid-career, and late-career groups. In our military population, new recruits had higher frequency of femoral neck, femoral shaft, and pelvic fractures, but lower frequency of foot fractures when compared to other patient groups. New recruits also had multiple fractures more often than other patients groups at the time of presentation. Presentation: 6/1/2024