Assessing the Risk of Stress Fractures in Young Male Athletes: A Cross-sectional Study on the Relationship between Intercondylar Distance and Stress Fractures and between Vitamin D3 Levels and Stress Fractures
Abstract
Stress fractures, resulting from repetitive stress, are common amongst athletes and high-impact activity participants. Although Vitamin D deficiency has been linked to higher stress fracture risk, recent studies show inconsistent results. In addition, intercondylar distance (ICD), the space between medial femoral condyles when standing with malleoli approximated, has not been examined for its role in stress fractures. This study evaluates the relationships between ICD, Vitamin D levels and stress fracture incidence in young male recruits.
Population: 200 male recruits, aged 18–25 years, from a military training facility in Eastern India. Inclusion: Recruits with bony pain in the lower limbs diagnosed with stress fractures. Exclusion: Knock knees (medial malleoli distance >5 cm). Assessments: X-rays for suspected fractures. Vitamin D measured by the enzyme-linked immunosorbent assay, classified into deficient (40 ng/mL). ICD measured and categorised as normal (≤4 cm) or abnormal (>4 cm). Statistical analysis: Chi-square test and Cramér’s V coefficient assessed associations.
Amongst participants, 52% had normal Vitamin D levels, 77% had abnormal ICD and 16% experienced stress fractures. Vitamin D deficiency (<20 ng/ml) was linked to a 71% probability of fracture and abnormal ICD increased fracture probability to 36% even with normal Vitamin D levels.
This study highlights Vitamin D deficiency and ICD malalignment as associated fracture risk factors. It supports implementing…
How strong is the evidence?
Evidence Hub reads this as a cross-sectional, done in people. Its evidence level is 4 of 5 (Low · observational). Observational designs can show an association but not prove cause.
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