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Sex and occupation are salient factors associated with lateral ankle sprain risk in military tactical athletes

  • John J. Fraser
    Correspondence
    Corresponding author.
    Affiliations
    Foot & Ankle Subcommittee, Neuromusculoskeletal Clinical Community Advisory Board, US Navy Bureau of Medicine and Surgery, Falls Church, VA, USA

    Warfighter Performance Department, Directorate for Operational Readiness & Health, Naval Health Research Center, San Diego, CA, USA
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  • Andrew J. MacGregor
    Affiliations
    Foot & Ankle Subcommittee, Neuromusculoskeletal Clinical Community Advisory Board, US Navy Bureau of Medicine and Surgery, Falls Church, VA, USA

    Medical Modeling, Simulation, and Mission Support Department, Naval Health Research Center, San Diego, CA, USA
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  • Camille P. Ryans
    Affiliations
    Foot & Ankle Subcommittee, Neuromusculoskeletal Clinical Community Advisory Board, US Navy Bureau of Medicine and Surgery, Falls Church, VA, USA

    Department of Orthopedic Surgery, Naval Hospital Jacksonville, Jacksonville, FL, USA
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  • Mark A. Dreyer
    Affiliations
    Foot & Ankle Subcommittee, Neuromusculoskeletal Clinical Community Advisory Board, US Navy Bureau of Medicine and Surgery, Falls Church, VA, USA

    Podiatry Clinic, Naval Health Clinic New England, Newport, RI, USA
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  • Michael D. Gibboney
    Affiliations
    Foot & Ankle Subcommittee, Neuromusculoskeletal Clinical Community Advisory Board, US Navy Bureau of Medicine and Surgery, Falls Church, VA, USA

    Orthopedics Department, Naval Medical Center Camp Lejeune, Camp Lejeune, NC, USA
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  • Daniel I. Rhon
    Affiliations
    Physical Performance Service Line, G-3/5/7, US Army Office of the Surgeon General, Falls Church, VA, USA

    Center for the Intrepid, Brooke Army Medical Center, Joint Base San Antonio-Fort Sam Houston, San Antonio, TX, USA
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      Abstract

      Objectives

      To assess the risk of lateral ankle sprain (LAS) in male and female tactical athletes across different military occupations in the US military.

      Design

      Retrospective cohort.

      Methods

      The Defense Medical Epidemiology Database was queried for the number of individuals with ICD-9 diagnosis codes 845.00 (sprain of ankle, unspecified) and 845.02 (calcaneofibular ligament sprain) on their initial encounter from 2006 to 2015. Relative risk (RR) and chi-square statistics were calculated assessing sex and occupational category on LAS risk.

      Results

      272,970 enlisted males (27.9 per 1000 person-years), 56,732 enlisted females (34.5 per 1000 person-years), 24,534 male officers (12.6 per 1000 person-years), and 6020 female officers (16.4 per 1000 person-years) incurred a LAS. Enlisted females in all occupational groups were at significantly higher risk for LAS than their male counterparts (RR 1.09–1.68; p < 0.001), except for Engineers (p = 0.15). Female officers had consistently higher risk for LAS in all occupational groups (RR 1.10–1.42; p < 0.001) compared with male officers, except Ground/Naval Gunfire (p = 0.23). Contrasted with Infantry, enlisted tactical athletes in the Special Operations Forces, Mechanized/Armor, Aviation, Maintenance, and Maritime/Naval Specialties were at lower risk (RR 0.38−0.93; p < 0.001), Artillery, Engineers, and Logistics Specialties were at higher risk (RR 1.04–1.18; p < 0.001), and Administration, Intelligence, and Communications were no different (p = 0.69). Compared with Ground/Naval Gunfire officers, Aviation officers were at significantly lower risk (RR, 0.75; p < 0.001), and Engineers, Maintenance, Administration, Operations/Intelligence, and Logistics officers were at higher risk (RR, 1.08–1.20; p < 0.001).

      Conclusions

      Sex and military occupation were salient factors associated with LAS risk.

      Keywords

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