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Low Vitamin D Levels Are Associated With Longer Healing Times in Pediatric Fracture Patients
Michael Guyot1, William Ross1, Catalina Baez2
1Department of Orthopaedic Surgery, College of Medicine, University of Florida, Gainesville, FL, USA.
Insights
Low vitamin D levels in children correlate with longer healing times for fractures, especially in lower extremities and after surgery. This highlights the importance of assessing vitamin D status in pediatric fracture patients experiencing delayed recovery.
Area of Science:
- Orthopedics
- Pediatric Medicine
- Endocrinology
Background:
- Vitamin D is vital for bone health and calcium absorption.
- Previous research focused on adult fracture prevention, leaving pediatric fracture healing underexplored.
- This study examines the link between vitamin D levels and healing duration in pediatric fractures.
Purpose of the Study:
- To investigate the correlation between low vitamin D levels and prolonged healing times in pediatric fractures.
- To identify specific patient groups within the pediatric population who may be more susceptible to delayed healing due to low vitamin D.
- To inform clinical practice regarding vitamin D assessment in children with fractures.
Main Methods:
- Retrospective review of pediatric patients (0-17 years) with extremity fractures.
- Data collected on demographics, injury details, treatment, outcomes, and vitamin D levels (normal >30.0 ng/mL, low ≤29.9 ng/mL).
- Study conducted at a single institution in the southeastern US from January 2015 to May 2022.
Main Results:
- 61.4% of patients had low vitamin D levels.
- Low vitamin D was associated with significantly longer clinical and radiographic healing times (P=.019, P=.001).
- Prolonged healing was more pronounced in lower extremity fractures and in patients requiring surgery.
Conclusions:
- Low vitamin D levels are linked to delayed healing in pediatric fractures.
- Pediatric orthopaedic surgeons should consider vitamin D evaluation in patients with prolonged healing.
- Early assessment and supplementation may improve outcomes for pediatric fracture patients with low vitamin D.
Background:
Vitamin D plays a crucial role in bone health by aiding calcium absorption. While prior studies have explored the relationship between vitamin D and fracture prevention in adults, its impact on pediatric fracture healing remains underexplored. This study investigates whether low vitamin D levels correlate with longer healing time in pediatric fractures.
Methods:
A retrospective review of patients (ages: 0-17 years) with extremity fractures and vitamin D levels within a year of injury was conducted at a single institution in the southeastern United States from January 2015 to May 2022. Data were collected on demographics, medical history, injury specifics, treatment, outcomes, and vitamin D levels and supplementation. Serum vitamin D levels greater than 30.0 ng/mL were defined as "normal" and levels at or below 29.9 ng/mL were defined as "low".
Results:
Among 166 patients with 186 fractures, normal vitamin D levels were observed in 38.6% of patients and low vitamin D in 61.4% of patients. Patients with low vitamin D levels had longer clinical (P = .019) and radiographic (P = .001) healing times than those with normal levels. Patients with lower extremity fractures and low vitamin D had longer clinical (P = .025) and radiographic healing times (P = .006). Similarly, within those who required operative management, low vitamin D patients had significantly longer clinical (P = .031) and radiographic (P = .043) healing times.
Conclusions:
Our study demonstrates that low vitamin D levels are associated with prolonged clinical and radiographic healing in pediatric patients with fractures, particularly in those with lower extremity fractures and those requiring surgery. Pediatric orthopaedic surgeons should consider evaluation of vitamin D levels in these patients, as healing may be prolonged in patients with low vitamin D levels.
Key Concepts:
(1)Pediatric patients with low vitamin D levels had longer time to clinical return to activity.(2)Pediatric patients with low vitamin D levels had longer time to radiographic healing.(3)Clinicians should be suspicious of low vitamin D in a pediatric fracture patient with prolonged healing.
Level Of Evidence:
Level III, Cohort Study.
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