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Original Article

Bone Stress Injuries Are Common in Female Military Trainees: A Preliminary Study

Maria H. Niva1, 2, 3, Ville M. Mattila1, 4 Contact Information, Martti J. Kiuru1, 2, 3 and Harri K. Pihlajamäki1, 5

(1)  Centre for Military Medicine, Helsinki, Finland
(2)  Department of Radiology, Central Military Hospital, Helsinki, Finland
(3)  Department of Radiology, Helsinki University Central Hospital, Helsinki, Finland
(4)  Hämeenlinna Central Hospital, Hämeenlinna, Finland
(5)  Department of Orthopaedic Surgery, Central Military Hospital, Helsinki, Finland

Received: 26 September 2008  Accepted: 7 April 2009  Published online: 21 April 2009

Abstract  Although bone stress injuries are common in male military trainees, it is not known how common they are in female trainees. It also is unclear whether asymptomatic bone stress injuries heal if intensive training is continued. We prospectively followed 10 female trainees of a military Reserve Officer Course. The subjects underwent clinical and MRI examinations of the pelvis, thighs, and lower legs at the beginning, once during, and at the end of their 3-month course. We identified two to five injuries in every female trainee, all of whom already had the injuries at the beginning of the officer course. None of these injuries increased their severity despite vigorous training. Two-thirds were asymptomatic and low grade. Femoral and tibial shafts were the most common locations. Higher-grade injuries were more likely symptomatic, but regardless of the MRI findings, female trainees expressed only mild to moderate symptoms. Asymptomatic, low-grade bone stress injuries of the femoral and tibial shaft are common in female recruits undergoing heavy physical training. Because these injuries seem to remain constant or even disappear despite continued heavy physical activity, we do not recommend routine screening of asymptomatic trainees. As some bone stress fractures may have severe consequences (eg, in the femoral neck), symptomatic bone stress injuries should be examined and treated.
Each author certifies that he or she has no commercial associations (eg, consultancies, stock ownership, equity interest, patent/licensing arrangements, etc) that might pose a conflict of interest in connection with the submitted article.
Each author certifies that his or her institution has approved the human protocol for this investigation, that all investigations were conducted in conformity with ethical principles of research, and that informed consent for participation in the study was obtained.
This work was performed at Central Military Hospital.

Contact Information Ville M. Mattila
Email: ville.mattila@uta.fi

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