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Vitamin K therapy for cortical bone fragility caused by reduced mechanical loading in a child with hemiplegia

T Sugiyama1, T Takaki, T Saito

  • 1Department of Orthopaedic Surgery, Yamaguchi University School of Medicine, Yamaguchi, Japan. tsugiyama@rvc.ac.uk

Journal of Musculoskeletal & Neuronal Interactions
|October 20, 2007
PubMed

Insights

Vitamin K supplementation may improve bone strength in children with cerebral palsy. This case study showed increased bone size and resistance to fracture after eight months of vitamin K treatment in a child with hemiplegia.

Area of Science:

  • Pediatric Orthopedics
  • Bone Biology
  • Nutritional Science

Background:

  • Children with cerebral palsy (CP) often experience fractures at cortical bone sites.
  • Reduced mechanical loading in CP can lead to decreased bone mass and increased fragility.
  • Current therapeutic options for bone fragility in pediatric CP are limited.

Observation:

  • A case report involving an eight-year-old ambulatory boy with right-sided hemiplegic cerebral palsy.
  • The patient received oral vitamin K (15 mg/day) for eight months.
  • Cortical bone geometry of bilateral tibiae was assessed before and after treatment.

Findings:

  • The hemiplegic tibia showed a significant 63.7% increase in the polar moment of inertia, indicating enhanced resistance to torsional forces.
  • The non-hemiplegic tibia experienced a 13.0% increase in polar moment of inertia.
  • Both tibiae demonstrated changes in cross-sectional areas, with the hemiplegic tibia showing a notable increase in bone area (14.9%) and a decrease in marrow area (-3.4%).

Implications:

  • Vitamin K may play a crucial role in mitigating cortical bone fragility associated with reduced mechanical loading in pediatric CP.
  • Potential therapeutic benefits of vitamin K in improving bone geometry and strength in this population.
  • Further research is warranted to confirm these findings and elucidate the underlying mechanisms of vitamin K action on bone.

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