Military Fractures: Overtraining, Accidents, Casualties, and Fragility

Fractures sustained by military personnel are prevalent and costly both in the lives of individual service members and in consideration of overall military readiness. Training, environment, and hazards change throughout and after a military career. During training, military recruits are susceptible to stress fractures through overtraining. In both non-deployed and deployed non-battle environments, the most likely cause of fractures to service members is through mechanisms regularly encountered in civilian environments, including motor vehicle accidents and falls. In combat environments, however, fractures are typically sustained through targeted violent mechanisms such as explosions and gunshot wounds that often cause injury leading to long-term disability. Bone fragility is the primary cause of fracture for veterans. Fractures in the military maintain an incidence rate and injury mechanism similar to that in the civilian population, with the exception to battlefield casualties, while contributing a similar burden to the work force through limiting sustainable activity and increasing costs associated with treatment and recovery from injury. Greatly influencing the impact of fractures in the military is the mechanism of injury and the environment in which they are sustained.