军事训练致女兵耻骨支应力性骨折的回顾性调查

A Retrospective Study on Stress Fractures of Pubic Ramus of Women Soldiers during Military Training

目的对军事训练过程中女兵发生耻骨支应力性骨折情况进行调查分析,并探讨防治措施。方法对2010年1月—2015年1月在解放军59医院及体系部队卫生机构就诊的106名女兵发生耻骨支应力性骨折的情况进行回顾性调查分析。结果发生13例共有18处骨折,总发生率为12.26%(13/106)。单侧耻骨下支骨折8例,双侧耻骨下支骨折1例,同侧耻骨上下支骨折4例;左侧8例,右侧4例,双侧1例。出现首发症状的训练科目主要为负重行军、队列训练、越野跑等。13例均存在不同程度的误诊、漏诊,经治疗后均痊愈。随访2年均无复发,能继续参加军事训练。结论耻骨支应力性骨折是一种女兵常见军事训练伤,且易漏诊、误诊,应高度重视、加深认识,军事训练时注意性别差异,科学合理安排。

Objective To investigate the conditions of stress fractures of pubic ramus in female army soldiers during military training and to study the prevention and control measures. Methods Conditions of 106 female army soldiers with stress fractures of pubic ramus during January 2010 and January 2015 were retrospectively analyzed. Results There were 18 stress fractures of the pubic ramus in 13 female army soldiers, and the total incidence rate was 12.26% （13/106） ; which included 8 patients with stress fractures of unilateral inferior pubic ramus, 1 of bilateral inferior pubic ramus and 4 of ipsilateral superior and inferior pubic ramus ; there were 8 patients with left fractures, 4 patients with right fractures and 1 patient with both sides. The training courses caused first symptom from weight-bearing march, queue training and cross-country running in turns. The different degrees of misdiagnosis or missed diagnosis were found in the 13 patients. All the patients were cured after the treatment, and had no recurrence within two years of follow-up. All the patients could take part in the military training after recovery. Conclusion The stress fractures of pubic ramus is a common training injury for female army soldiers, and it can be easily misdiagnosed or missed diagnosis. More attention should be paid to the gender differences, and military training should be scientifically and reasonablily organized.