Objectives: The aim of this study was to explore the relationship between stress fractures, bone density and factors related to bone metabolism in a comparative group matched study including male military personnel beyond basic training.

Materials and Methods: Thirty two patients with stress fractures were matched with 32 uninjured-healthy volunteers (controls), by gender, age, height, body weight and level of physical performance. A questionnaire concerning the calcium intake, alcohol consumption and smoking was completed, the values of several biochemical markers related to bone metabolism were measured from blood samples, and calcaneal quantitative ultrasound was measured by heel ultrasound for each one of the 64 patients and healthy volunteers.

Results: Statistically significant lower levels of serum Osteocalcin (p=0.012) and higher levels of Albumin (p=0.006) were found among patients compared to controls. The levels of serum Total Protein, Ca, intact Parathormone and 25-hydroxy Vitamin D were lower among patients compared to controls, but none of these differences was statistically significant (all p> 0.10). Moreover, mean values of T-scores and Z-scores were statistically significantly lower in patients than in controls (p=0.018 for T-scores; p=0.016 for Z-scores).

Conclusions: Decreased bone turnover and low calcaneal bone density may increase the incidence of lower extremity stress fractures among men military personnel.