| Purpose Stress fracture is one of the most common sports injuries in the army.The medical costs and non-combat attrition caused by stress fracture have brought huge burden to the army.Most of the previous studies focused on the risk factor analysis of stress fracture,but there are few studies on the prevention of it.In this study,an epidemiological survey was conducted on recruits who enlisted in a military training base in 2021,and observation and evaluation were conducted during the 12-week basic military training.Their basic information and the occurrence of stress fractures throughout the basic military training were collected,and potential risk factors for stress fractures were analyzed.On this basis,a single-center randomized controlled trial was conducted to evaluate the efficacy and safety of vitamin D combined with calcium in the prevention of stress fractures.Therefore,it can provide high-quality evidence for the screening of high-risk stress fracture in the army,adjustment of training program and prevention of stress fracture.Method 1.The basic information such as general conditions,body measurement indicators,living habits and training conditions of all the subjects were collected through a combination of questionnaires,physical examinations and symptoms assessment.Stress fracture cases were diagnosed by a combination of medical history,physical examination and imaging examinations.The epidemiological characteristics and possible risk factors of stress fractures in recruits were obtained.2.Collected the basic information of all subjects participating in the second part of the study,draw blood samples before the intervention,and randomly divided all subjects into two groups to compare the baseline levels of the two groups.The intervention group was given 1000 IU of vitamin D3 and 1200 mg of calcium daily,and the control group was given a placebo.The incidence of stress fractures in the two groups was compared.Result 1.We selected 637 recruits from a military training base who enlisted in the army in March 2021.The overall incidence of stress fractures is 14.1%.The tibia is the most common location of stress fractures(55 cases,accounting for 61.1%),followed by tarsal bone(26 cases,accounting for 28.9%),metatarsal bone(4 cases,accounting for 4.4%),femur(4 cases,accounting for 4.4%)and fibula(1 case,accounting for 1.1%).Gender(female),history of lower extremity fractures,picky eaters(whether or not to eat foods rich in VD and calcium,such as fish,pork liver,mushrooms,milk,etc.)and previous VD supplementation are significantly different between the stress fracture group and the nonstress fracture group.The OR values were 4.883,8.483,5.049,0.407,respectively.2.We selected 350 recruits from the same military training base who enlisted in the army in September 2021.6 of them were excluded from this study because they had other injuries.A total of 176 people were included in the intervention group,12 of them developed stress fractures,with an incidence of 6.8%,and 168 people were included in the control group,26 of them had stress fractures,with an incidence of 15.5%.The difference between the two groups was statistically significant(P<0.05).Conclusion 1.This study shows that the incidence of stress fractures among recruits is14.1%.The tibia has the highest incidence of stress fracture,followed by the tarsal bone.Gender,history of lower extremity fractures,picky eaters(whether or not to eat foods rich in VD and calcium,such as fish,pork liver,mushrooms,milk,etc.)and previous VD supplementation can be used as risk indicators for stress fractures in recruits.2.Daily supplementation of 1000 IU of vitamin D3 and 1200 mg of calcium can effectively prevent the occurrence of stress fractures in male recruits during basic military training.This intervention method is simple,safe and effective,and can be used as a theoretical basis and method for the prevention of stress fractures in the army in the future. |
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