Lower limb pain and disability following strenuous activity

Area of Science:

• Orthopedics
• Sports Medicine
• Military Health

Background:

• Lower limb pain is common in military recruits undergoing strenuous physical activity.
• Stress fractures are a frequent cause of pain, impacting training and readiness.
• The role of anatomical variations in stress fracture development is not fully understood.

Purpose of the Study:

• To investigate the prevalence and characteristics of lower limb stress fractures in military recruits.
• To evaluate the diagnostic accuracy of plain radiography and technetium-99m polyphosphate scans.
• To explore the association between anatomical deformities and stress fractures.

Main Methods:

• Evaluation of 105 military recruits with lower limb pain using clinical examination.
• Diagnostic imaging including plain radiography and technetium-99m polyphosphate scintigraphy.
• Assessment for anatomical abnormalities of the lower limbs.

Main Results:

• Stress fractures were identified in 52.4% of recruits, predominantly in the tibial and femoral diaphyses.
• Plain radiography showed a high rate of false negatives (87.3%) for documented stress fractures.
• A significant proportion of recruits without stress fractures (74%) exhibited anatomical deformities, particularly of the feet.

Conclusions:

• Stress fractures are a substantial issue in military recruits, with scintigraphy proving more sensitive than radiography.
• Anatomical deformities of the lower limb may be associated with the development of stress fractures.
• Correction of deformities facilitated return to strenuous activity, suggesting a potential management strategy.