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Published on: March 13, 2026
Return to Push-ups After Distal Radius Fractures Among Active Duty Service Members in the United States Military: A
Mark W Schmitt1, Elliott V Rebello1, Matthew M Mcdonough1
1Department of Orthopedic Surgery, Womack Army Medical Center, Fort Bragg, NC 28310, United States.
Introduction:
Distal radius fractures (DRFs) are a significant musculoskeletal injury among military personnel. We hypothesize that distal radius fractures negatively impact post-injury push-up scores and that intra-articular fractures treated surgically result in the greatest decline.
Materials And Methods:
The U.S. Military Medical Assessment and Readiness System (MARS) database was used to identify 12,953 unique individuals diagnosed with DRFs. Sociodemographic and occupational data were obtained, and electronic health records provided clinical data including physical measures and diagnoses. Among U.S. Army service members (SMs), pre-injury push-up scores were compared with the first two post-injury or post-surgery push-up scores. Three treatment groups were defined: non-surgical, extra-articular surgical, and intra-articular surgical. Pairwise comparisons of mean push-up change were evaluated using a Bonferroni-adjusted significance threshold (α = .0083) for 6 planned comparisons.
Results:
From 2011 to 2023, the incidence rate of DRFs decreased from 7.5 cases per 10,000 person-years in 2011 to 6.1 in 2023 (approximately a 19% relative decrease). The mean age at injury was 28 years (SD = 8) and mean BMI was 26 (SD = 3). Most DRFs occurred among Army and Navy SMs (38.48% and 23.78%, respectively), with nearly half occurring among enlisted SMs. Open fractures represented 0.6% and intra-articular fractures 18% of DRFs. In total, 6.5% underwent intra-articular surgical reduction and fixation and 11.4% underwent extra-articular surgical repair. Among those treated surgically, 7.8% also underwent carpal tunnel release at the time of surgery or within 2 years after fracture repair. Among U.S. Army SMs with push-up data (n = 3,418), the mean change in push-ups at the first post-injury or post-surgery fitness test was -3.4 (SD = 11.2) in the non-surgical group, -4.4 (SD = 12.2) in the intra-articular surgical group, and -5.7 (SD = 12.4) in the extra-articular surgical group. Using the Bonferroni-adjusted threshold, no pairwise comparisons met statistical significance at the first or second post-injury or post-surgery fitness test.
Conclusions:
This study demonstrates a declining trend in DRF incidence within the U.S. Military population over the study period. Functional recovery following non-operative and operative management of DRF converged by one year post-injury. Continued surveillance of these injuries among service members is important for optimizing operational readiness.
