Stress fractures in the Israeli Defense Forces from 1995 to 1996

This study, encompassing 2591 Israeli soldiers, characterized Israeli soldi ers with stress fractures to profile individuals who are prone to experienc e stress fractures: 318 with clinically and scintigraphically proven high g rade stress fractures; 237 soldiers with symptoms but with normal scintigra phy; and 2036 soldiers with no symptoms. Soldiers with high grade stress fr actures weighed less (68.4 +/- 7.9 kg versus 70.5 +/- 12.4 kg), smoked less , and reported fewer previous stress fractures, had fewer reports of stress fractures in their family histories, and had fewer incidences of bone dise ases than did control subjects. Serum levels of bone specific alkaline phos phatase and osteocalcin were elevated in patients with high grade stress fr actures compared with control subjects with no symptoms: 37.6 versus 26.2 u nits/L, and 10.8 versus 8.8 ng/mL, respectively. Levels of 25-hydroxy vitam in D were lower in patients with high grade stress fractures (25.3 ng/mL) t han in control subjects (29.8 ng/mL), This study revealed that several para meters can distinguish soldiers with high grade stress fractures, but their predictive value and precise pathogenetic role remain unclear.