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Biomechanical and Anthropometic Measures of Nunns et al for Avoiding Tibial Stress Fractures in Military Recruits

Description

Nunns et al studied tibial stress fractures in Royal Marine recruits. They identified biomechanical and anthropometric measures associated with these injuries. The authors are from the University of Exeter and the Institute of Naval Medicine (Alverstoke) in England.


 

Patient selection: marine recruits

 

Outcome: tibial stress fracture (TSF)

 

Parameters:

(1) body mass index (BMI)

(2) bimalleolar width

(3) tibial rotation range of motion = difference between peak internal and external rotation

(4) peak heal pressure

 

Parameter

Tibial Stress Fractures are reduced if

body mass index

> 25 kg per square meter

bimalleolar width

> 74 mm

tibial range of motion

greater than 13 degrees

peak heel pressure

less than 13 N per square cm

 

The risk of tibial stress fracture can be significant at extreme values.

 

Parameter

Extreme Value

Risk of TSF

body mass index

19 kg per sq meter

35%

bimalleolar width

59 mm

50%

internal tibial rotation

1 degree

25%

peak heel pressure

29 N per square cm

30%

 

 

Parameter

Risk of TSF > 10% if

body mass index

< 23 kg per sq meter

bimalleolar width

< 69 mm

internal tibial rotation

< 8.5 degrees

peak heel pressure

> 20 N per square cm

 


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