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Journal of Bone and Joint Surgery, 1944;26:743-750.
© 1944 by The Journal of Bone and Joint Surgery, Inc

MARCH FRACTURE

A Report of Three Hundred and Seven Cases and a New Method of Treatment

Abraham Bernstein 1 and Joseph R. Stone 1

1 Medical Corps, Army of the United States

From this series of 307 cases of march fracture, certain pertinent conclusions can be drawn.

1. Prior to the introduction of "speed hikes" and prolonged marches in the curriculum of basic training, march fractures were rare entities. Soon after this change in the curriculum occurred, we commenced seeing this syndrome.

2. This pathological condition occurred in soldiers irrespective of age, height, weight, and general body build.

3. No usual or unusual deformities of the foot were associated with this condition.

4. One or more of the metatarsals may be involved at the same time, or at different times during the same training cycle.

5. There is no relation between pre-induction occupation and the development of a march fracture.

6. Contrary to general opinion, this condition does occur in the colored soldier, although not nearly so frequently as in the white soldier.

7. The treatment, as described in this paper, was found to be adequate enough to keep the soldier on duty without missing the greater portion of his training. After six to eight weeks, the soldier is able to perform his duties as well as the man who never had a march fracture.

8. The method of treatment described saves innumerable hospital and training days.

9. In our opinion, the treatment of a march fracture of the foot by immobilization in a plaster-of-Paris bandage, as described in the literature, is not indicated, since this is not a complete fracture, and there is no loss of position or alignment. Furthermore, rigid immobilization causes a bone and muscle atrophy of the involved foot and leg. When the plaster cast has been removed, it is necessary for the patient to receive physiotherapy over a period of several weeks before he can return to his normal duties. With our method of treatment, all this is obviated.


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