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.
- Yet again, 800 IU of vitamin D was found to be barely enough to help bones – Lancet Oct 2013
- Guideline following hip fracture – 50000 IU vitamin D daily for 7 days – Jan 2013
- Vitamin D and fractures – 24 meta-analyses and counting – Dec 2014
- Nonunion after elective foot or ankle reconstruction 8 times more likely if low vitamin D – May 2017
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.
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.
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.
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.
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