Fractures among active component, recruit trainees, and deployed service members, U.S. Armed Forces, 2003-2012

Injuries are the leading cause of healthcare encounters and lost work days among military service members in the U.S. Armed Forces. Fractures often entail a lengthy recovery time and can affect the operational ability of both the individual and the unit. From 1 January 2003 through 31 December 2012, active component service members were diagnosed with 244,248 incident fractures (19.4 per 1,000 person-years[p-yrs]). Hand and foot/ankle fractures were the most common types. During the same surveillance period, recruit trainees were diagnosed with 18,773 incident fractures (66.0 per 1,000 p-yrs). Annual incidence rates among trainees declined 38% from 2003 to 2012. Stress fractures were the most common type in this population. From 1 January 2008 through 31 December 2012, deployed service members were diagnosed with 12,328 incident fractures (16.5 per 1,000 p-yrs). The most common sites of fracture among the deployed population were of the hand, foot/ankle, and arm. Comments address preventive interventions, stress fractures in trainees, gender differences in incidence, and limitations of the study.