Children who are deficient in vitamin D appear to have a greater risk for more severe forearm fractures requiring surgical treatment, according to a study presented at the American Academy of Orthopaedic Surgeons (AAOS) annual meeting in New Orleans.
According to the researchers, this study suggests a link between low vitamin D levels and the severity of fractures in children caused by low-energy, less traumatic events such as falling off a bike or falling while running.
“Not only are forearm fractures common in children, but so is vitamin D deficiency and insufficiency,” says Pooya Hosseinzadeh, MD, assistant professor, Department of Orthopaedic Surgery at Washington University School of Medicine in St Louis, in a media release.
“Knowing that vitamin D deficiency can lead to negative calcium balance, low bone mineral density and quality leading to compromised bone strength, it makes sense for patients to be more susceptible to fractures at lower impact load and more susceptible to greater severity when fractures do occur.”
The study included 100 children (ages 3 to 15; 65% male, 35% female) with low-energy forearm fractures. Each participant filled out a questionnaire focusing on risk factors for vitamin D deficiency. The mean 25-hydroxyvitamin D (25[OH]D) concentration was 27.5 + 8.3 ng/ml.
The fractures were then categorized as requiring non-operative or operative management. The children’s vitamin D status was based on measurement of 25(OH)D concentration obtained during the clinic visit, and was compared between the two fracture groups, per the release.
Using Endocrine Society guidelines, 21% of patients were vitamin D deficient (25(OH)D < 20 ng/ml) and 49% had vitamin D insufficiency (25(OH)D: 21 – 29 ng/ml), according to the researchers. There was a dramatic difference in incidence rates of vitamin D deficiency between those treated surgically (50%) compared to those in the non-operative group (17%).
Being vitamin D deficient was also associated with a greater risk of needing operative management (28.6% versus 7.6% non-operative). Being overweight/obese and nonwhite increased the likelihood of vitamin D deficiency.
Among the children in the operative group, 75% were obese or overweight, compared to only 32% of children in the non-operative group. Patients requiring operative management were older than 10 years of age and had greater BMI than patients not requiring surgery, the release explains.
“This study provides an important takeaway for parents and pediatricians,” Hosseinzadeh explains. “If a child does have a forearm fracture, we would encourage the physician to check the patient’s vitamin D levels. The good news is that in most cases, children can reduce deficiency with a vitamin D supplement and increasing outdoor activity.”
[Source(s): American Academy of Orthopaedic Surgeons, PR Newswire]