TY - JOUR
T1 - Vitamin D Status in Children Wit Forearm Fractures
T2 - Incidence and Risk Factors
AU - Hosseinzadeh, Pooya
AU - Mohseni, Mahshid
AU - Minaie, Arya
AU - Kiebzak, Gary M.
N1 - Funding Information:
This study was funded by the Baptist Children's Hospital Foundation.
Publisher Copyright:
Copyright © 2020 The Authors
PY - 2020/8/1
Y1 - 2020/8/1
N2 - Introduction: The association between vitamin D status and fracture characteristics in children remains ambiguous. We hypothesized that vitamin D deficient or insufficient children would have an increased risk of forearm fractures severe enough to require surgical management. Methods: One hundred children with low-energy forearm fractures were prospectively enrolled from a single hospital. Each participant answered a questionnaire focusing on the risk factors for vitamin D deficiency. Fractures were categorized as requiring nonsurgical or surgical management. Vitamin D status was based on the measurement of 25-hydroxyvitamin D (25(OH)D) concentration obtained during the clinic visit and compared between the two fracture groups. Results: The cohort exhibited a mean age of 9.8 ± 3.2 years (range: 3-15 years), comprising 65 (65%) men and 35 (35%) women. Overall, mean 25(OH)D was 27.5 ± 8.3 ng/mL. Using the Endocrine Society guidelines, 21% of patients were categorized as “vitamin D deficient” (25(OH)D ≤ 20 ng/mL) and 49% as “vitamin D insufficient” (25(OH)D: 21 to 29 ng/mL). Stratification by intervention revealed a mean 25(OH)D of 23.3 ± 8.8 ng/mL in the surgical group (n = 12) and 28.1 ± 8.1 in the nonsurgical group (n = 88) (P = 0.057). Fifty percent of the surgical group were “vitamin D deficient” compared with 17% of the nonsurgical group (P = 0.017). The relative risk of requiring surgical treatment in children with forearm fracture and vitamin D deficiency (25(OH)D, 20 ng/mL) was 3.8. 25(OH)D level, negatively correlated with body mass index (r = -0.21, P = 0.044); 9 surgical patients were overweight or obese (as defined by the criteria of the Centers for Disease Control and Prevention). 25(OH)D level was significantly lower in non-Caucasians compared with Caucasians (26.0 ± 7.2 versus 32.5 ± 9.9 ng/mL; P = 0.0008). Discussion: Vitamin D deficiency is common in children with forearm fractures and may be a contributing risk factor for forearm fractures requiring surgical management in children. Conclusion: Vitamin D deficiency and inefficiency are common in children with low energy forearm fractures, especially in obese children and in fractures requiring surgical treatment.
AB - Introduction: The association between vitamin D status and fracture characteristics in children remains ambiguous. We hypothesized that vitamin D deficient or insufficient children would have an increased risk of forearm fractures severe enough to require surgical management. Methods: One hundred children with low-energy forearm fractures were prospectively enrolled from a single hospital. Each participant answered a questionnaire focusing on the risk factors for vitamin D deficiency. Fractures were categorized as requiring nonsurgical or surgical management. Vitamin D status was based on the measurement of 25-hydroxyvitamin D (25(OH)D) concentration obtained during the clinic visit and compared between the two fracture groups. Results: The cohort exhibited a mean age of 9.8 ± 3.2 years (range: 3-15 years), comprising 65 (65%) men and 35 (35%) women. Overall, mean 25(OH)D was 27.5 ± 8.3 ng/mL. Using the Endocrine Society guidelines, 21% of patients were categorized as “vitamin D deficient” (25(OH)D ≤ 20 ng/mL) and 49% as “vitamin D insufficient” (25(OH)D: 21 to 29 ng/mL). Stratification by intervention revealed a mean 25(OH)D of 23.3 ± 8.8 ng/mL in the surgical group (n = 12) and 28.1 ± 8.1 in the nonsurgical group (n = 88) (P = 0.057). Fifty percent of the surgical group were “vitamin D deficient” compared with 17% of the nonsurgical group (P = 0.017). The relative risk of requiring surgical treatment in children with forearm fracture and vitamin D deficiency (25(OH)D, 20 ng/mL) was 3.8. 25(OH)D level, negatively correlated with body mass index (r = -0.21, P = 0.044); 9 surgical patients were overweight or obese (as defined by the criteria of the Centers for Disease Control and Prevention). 25(OH)D level was significantly lower in non-Caucasians compared with Caucasians (26.0 ± 7.2 versus 32.5 ± 9.9 ng/mL; P = 0.0008). Discussion: Vitamin D deficiency is common in children with forearm fractures and may be a contributing risk factor for forearm fractures requiring surgical management in children. Conclusion: Vitamin D deficiency and inefficiency are common in children with low energy forearm fractures, especially in obese children and in fractures requiring surgical treatment.
UR - http://www.scopus.com/inward/record.url?scp=85108071173&partnerID=8YFLogxK
U2 - 10.5435/JAAOSGlobal-D-20-00150
DO - 10.5435/JAAOSGlobal-D-20-00150
M3 - Review article
C2 - 32852920
AN - SCOPUS:85108071173
SN - 2474-7661
VL - 4
JO - Journal of the American Academy of Orthopaedic Surgeons Global Research and Reviews
JF - Journal of the American Academy of Orthopaedic Surgeons Global Research and Reviews
IS - 8
M1 - e20.00150
ER -