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Prevalence of hypovitaminosis D among children with upper extremity fractures
Jeremy R James1, Patrick A Massey, Anne M Hollister
1Department of Orthopaedic Surgery, Louisiana State University Health Sciences Center, Shreveport, LA 71103, USA.
Insights
Hypovitaminosis D is prevalent in children with upper extremity fractures, with 65% showing insufficient or deficient 25-hydroxyvitamin D levels. African American children were disproportionately affected, highlighting the need for nutritional screening.
Area of Science:
- Pediatric Orthopedics
- Nutritional Science
- Public Health
Background:
- Recent studies indicate a high prevalence of vitamin D deficiency (hypovitaminosis D) in pediatric populations, including those with fractures.
- Vitamin D insufficiency is a growing concern impacting bone health and fracture healing in children.
Purpose of the Study:
- To determine the prevalence of hypovitaminosis D in children presenting with upper extremity fractures.
- To analyze the relationship between 25-hydroxyvitamin D levels and fracture characteristics.
- To inform fracture management and nutritional counseling strategies for pediatric patients.
Main Methods:
- Retrospective review of 213 pediatric upper extremity fracture cases over 14 months.
- Analysis of 25-hydroxyvitamin D levels for 181 patients at presentation or within 2 weeks.
- Categorization of vitamin D levels: normal (≥ 32 ng/mL), insufficient (20-32 ng/mL), deficient (< 20 ng/mL).
Main Results:
- A significant portion of children with fractures exhibited low vitamin D levels: 24% deficient, 41% insufficient.
- No correlation was found between vitamin D levels and fracture mechanism (high vs. low energy).
- African American children demonstrated a higher likelihood of insufficient or deficient vitamin D levels compared to other racial groups.
Conclusions:
- Hypovitaminosis D is a common comorbidity in children with upper extremity fractures.
- The 25-hydroxyvitamin D level may serve as a valuable screening tool for fracture risk assessment.
- Further research is needed to guide nutritional interventions for pediatric fracture patients.
Background:
Recent publications show a high rate of hypovitaminosis D among children in general as well as among children with fractures. 25-hydroxyvitamin D levels were analyzed from hospital records to determine the prevalence of hypovitaminosis D, with the goal of using that information in fracture management and nutritional counseling.
Methods:
We retrospectively reviewed the records of 213 children with upper extremity fractures that were treated during a 14-month period. For 181 of those patients, the 25-hydroxyvitamin D level was measured at the time of emergency department presentation or at the first clinic appointment within 2 weeks after the initial presentation. The following information was collected from the charts: fracture mechanism (high or low energy), age, sex, race, and body mass index. Vitamin D levels were categorized as normal (≥ 32 ng/mL), insufficient (20 to 32 ng/mL), or deficient (< 20 ng/mL). The levels were analyzed with respect to fracture pattern and race.
Results:
Of the 181 patients, 24% had deficient vitamin D levels, 41% had insufficient levels, and 35% had normal levels. There was no significant correlation with vitamin D level and mechanism of injury. African American children were more likely to have insufficient or deficient levels of vitamin D.
Conclusions:
Hypovitaminosis D is common among children with upper extremity fractures. Further investigation is warranted on the use of the 25-hydroxyvitamin D level as a screening tool to predict risk of fracture and to design proper nutritional programs for children with fractures.
Level Of Evidence:
Retrospective chart review; Level III evidence.
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