The Prevalence and Body Site Distribution of Stress Fractures among Female Combat Soldiers in the Israeli Defense Forces: A Cross-Sectional Study

Abstract

One of the most troublesome overuse injuries is stress fractures, for which female gender is a major risk factor. In 2015, the Israeli government opened identical combat duties for both genders. The purpose of this study is to provide a detailed report regarding the prevalence and characteristics of stress fractures in females that will serve as an evidence-based platform for future policy planning and implementation regarding female integration in combat units. This is a report of a cross-sectional study of 2223 female soldiers recruited to combat units between 2010 and 2013. Data were collected from the Israeli Defense Force's (IDF's) computerized medical consultation records package. Descriptive and analytic statistics were performed to obtain and analyze results. The overall stress fractures rate was 11.6% (258 soldiers). The most frequent site for stress fracture was the distal tibia (215 cases, 83%). The average lost training days due to a stress fracture were 26.6 days. The risk for developing a stress fracture was 2.15 (215%) times higher in the noninfantry group than in the infantry group, ( p = 0.0232, 95% confidence interval 1.346, 4.536). The rate of stress fractures and the consequent lost training days in the IDF are high and necessitate the planning and implementation of a comprehensive intervention policy to reduce overuse injuries and stress fracture rates among female warriors.