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      Aspects épidémiologiques des fractures de membres liées à l'exercice de la fonction militaire au Togo Translated title: Epidemiological aspects of limb fractures related to military exercises in Togo

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          Abstract

          Le but de notre étude était de déterminer la fréquence des fractures de membres liées à l'exercice de la fonction militaire au sein des Forces de Défense et de Sécurité en milieu africain en vue de ressortir l'impact des différentes circonstances de survenue. Nous avons entrepris une étude rétrospective descriptive allant du 1er janvier 2004 au 31 décembre 2013. Elle a concerné les agents des forces de défense et de sécurité traités pour des fractures de membres au cours de cette période. Sept cent quatre (704) cas de fractures de membres ont été dénombrés. L’âge moyen des patients était de 30,57 ans avec des extrêmes de 19 et 55 ans. La prédominance masculine était nette (95,71%). L'Armée de Terre (51,05%) et la Gendarmerie Nationale (38,86%) étaient les plus représentées. Les hommes du rang étaient majoritaires (43,08%), suivis des sous-officiers (32,59%). La fréquence annuelle des fractures de membres en rapport avec la profession militaire était de 63 cas. Les fractures de jambe étaient les lésions les plus recensées (32,96%). Les Formations et les stages militaires ont été les circonstances de survenue les plus rencontrées (42,60%), suivies des accidents de la circulation (39,43%). La perte des journées de service liée à ces lésions était estimée à 14009 jours par an. Les fractures de jambes occupent le premier rang des fractures de membres en rapport avec l'exercice de la profession militaire. Les formations-stages militaires et les accidents de la voie publique en sont les deux grandes circonstances de survenue.

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          Most cited references20

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          Risk factors for training-related injuries among men and women in basic combat training.

          Past investigations indicate that training-related injuries are associated with certain performance-oriented measures of physical fitness and certain lifestyle characteristics. This study examined associations between injuries, direct (physiological) measures of physical fitness, and lifestyle characteristics. Subjects were 756 men and 474 women performing the standardized activities involved in U.S. Army Basic Combat Training (BCT). Before BCT, a subsample of subjects (182 men and 168 women) were administered a series of tests that included a treadmill running test (peak VO2), dual-energy x-ray absorptiometry (for body composition), several measures of muscle strength, a hamstring flexibility test, and a vertical jump. A questionnaire addressed smoking habits and prior physical activity. All subjects were administered the Army Physical Fitness test consisting of push-ups, sit-ups, and a 3.2-km run. Gender, age, stature, and body mass were obtained from physical examination records. Injuries incurred during BCT were transcribed from medical records; for each medical visit, the diagnosis, anatomical location, disposition (final outcome of visit), and days of limited duty were recorded. Women had over twice the injury rate of men. For men and women, fewer push-ups, slower 3.2-km run times, lower peak VO2, and cigarette smoking were risk factors for time-loss injury. Among the men only, lower levels of physical activity before BCT and both high and low levels of flexibility were also time-loss injury risk factors. Multivariate analysis revealed that lower peak VO2 and cigarette smoking were independent risk factors for time-loss injury. Lower aerobic capacity and cigarette smoking were independently associated with a higher likelihood of injury in both men and women during a standardized program of physical training. Further studies are needed to assess associations between injury and body composition and muscular strength.
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            Epidemiology of injuries associated with physical training among young men in the army.

            It is widely acknowledged that musculoskeletal injuries occur as a result of vigorous physical activity and exercise, but little quantitative documentation exists on the incidence of or risk factors for these injuries. This study was conducted to assess the incidence, types, and risk factors for training-related injuries among young men undergoing Army infantry basic training. Prior to training we evaluated 303 men (median age 19 yr), utilizing questionnaires and measurements of physical fitness. Subjects were followed over 12 wk of training. Physical training was documented on a daily basis, and injuries were ascertained by review of medical records for every trainee. We performed univariate and multivariate analyses of the data. Cumulative incidence of subjects with one or more lower extremity training-related injury was 37% (80% of all injuries). The most common injuries were muscle strains, sprains, and overuse knee conditions. A number of risk factors were identified, including: older age, smoking, previous injury (sprained ankles), low levels of previous occupational and physical activity, low frequency of running before entry into the Army, flexibility (both high and low), low physical fitness on entry, and unit training (high running mileage).
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              Epidemiological patterns of musculoskeletal injuries and physical training.

              The purpose of this study was to identify rates of diagnosis-specific musculoskeletal injuries in U.S. Marine Corps recruits and to examine the association between patterns of physical training and these injuries. Subjects were 1,296 randomly selected male Marine recruits, ages 17 to 28 yr, who reported to Marine Corps Recruit Depot San Diego for boot camp training between January 12 and September 14, 1993. Recruits were followed prospectively through 12 wk of training for injury outcomes. Injury patterns were examined in relation to weekly volumes and types of vigorous physical training. The overall injury rate was 39.6% (number of recruits injured/population at risk), with 82% of injuries occurring in the lower extremities. Overuse injuries accounted for 78% of the diagnoses. The most frequent site of injury was the ankle/foot region (34.3% of injuries), followed by the knee (28.1%). Ankle sprains (6.2%, N = 1,143), iliotibial band syndrome (5.3%, N = 1,143), and stress fractures (4.0%, N = 1,296) were the most common diagnoses. Injury rates were highest during the weeks with high total volumes of vigorous physical training and the most hours of running and marching. Weekly injury rates were significantly correlated with hours of vigorous physical training (overuse injuries r = 0.667, P = 0.018; acute injuries r = 0.633, P = 0.027). The results of this controlled epidemiological investigation indicate that volume of vigorous physical training may be an etiologic factor for exercise-related injuries. The findings also suggest that type of training, particularly running, and abrupt increases in training volume may further contribute to injury risk.
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                Author and article information

                Journal
                Pan Afr Med J
                Pan Afr Med J
                PAMJ
                The Pan African Medical Journal
                The African Field Epidemiology Network
                1937-8688
                16 April 2015
                2015
                : 20
                : 377
                Affiliations
                [1 ]Service d'Orthopédie Traumatologie du CHU Sylvanus Olympio de Lomé, Togo
                [2 ]Service d'Orthopédie Traumatologie du CHU Kara, Togo
                [3 ]Service de Radiologie CHU Lomé, Togo
                [4 ]Service des Urgences Chirurgicales du CHU Sylvanus Olympio de Lomé, Togo
                Author notes
                [& ]Corresponding author: Yao Messanvi Akpoto, Service d'Orthopédie Traumatologie du CHU Sylvanus Olympio de Lomé, Togo
                Article
                PAMJ-20-377
                10.11604/pamj.2015.20.377.6340
                4816315
                27081434
                895e5b59-b828-4c84-90c9-35ca4803c42b
                © Yao Messanvi Akpoto et al.

                The Pan African Medical Journal - ISSN 1937-8688. This is an Open Access article distributed under the terms of the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 14 February 2015
                : 10 April 2015
                Categories
                Case Series

                Medicine
                fractures de membres,force de défense et de sécurité,formation militaire,togo,limb fractures,security forces,military

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