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Bone fractures heal poorly with only 1,000 IU of vitamin D (not a surprise) – Sept 2017

Do 25-Hydroxyvitamin D Levels Correlate With Fracture Complications?

J Orthop Trauma. 2016 Sep;30(9):e312-7. doi: 10.1097/BOT.0000000000000639.
Bodendorfer BM1, Cook JL, Robertson DS, Della Rocca GJ, Volgas DA, Stannard JP, Crist BD.

  • Department of Orthopaedic Surgery, MedStar Georgetown University Hospital, Washington, DC; †Department of Orthopaedic Surgery, University of Missouri, School of Medicine, Columbia, MO; and ‡Department of Orthopedics, Mid-Atlantic Permanente Medical Group, Largo, MD.


OBJECTIVES:
To determine the relationship between serum 25-hydroxyvitamin D [25(OH)D] levels and the likelihood of postoperative complications and fracture reoperation rate in orthopaedic trauma patients receiving vitamin D and calcium supplementation.

DESIGN: Retrospective case series.

SETTING: Level I trauma center, Midwestern United States.

PATIENTS:
All orthopaedic trauma patients-18 years or older-over a 20-month period were included with available initial and repeat 25(OH)D serum levels. In total, 201 patients met inclusion criteria.

INTERVENTION:
All patients received 1000 IU of vitamin D3 and 1500 mg of calcium daily. Vitamin D deficient and insufficient patients also received 50,000 IU of ergocalciferol (vitamin D2) weekly until 25(OH)D levels normalized or fractures healed.

MAIN OUTCOME MEASUREMENTS: fracture complications and 25(OH)D levels.

RESULTS:
Fifteen patients experienced postoperative healing complications. There was no significant difference between initial (P = 0.92) or repeat (P = 0.91) 25(OH)D levels between patients with and without fracture healing complications. Twenty-eight patients required repeat orthopaedic surgery. There was no significant difference between initial (P = 0.62) or repeat (P = 0.18) 25(OH)D levels between patients who did or did not require repeat orthopaedic surgery. There was no significant difference between initial (P = 0.66) or repeat (P = 0.89) 25(OH)D levels between patients who did or did not require nonorthopaedic surgery.

CONCLUSIONS:
Serum 25(OH)D levels did not significantly affect the likelihood of fracture healing complications requiring surgery or any nonorthopaedic injury-related surgery.

LEVEL OF EVIDENCE: Therapeutic Level IV.

PMID: 27253482 DOI: 10.1097/BOT.0000000000000639

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