Vitamin D deficiency and insufficiency impacts children's risk for severe forearm fractures

March 6, 2018, American Academy of Orthopaedic Surgeons

Children who are vitamin D deficient have a greater risk of having more severe forearm fractures requiring surgical treatment, according to a new study presented today at the 2018 Annual Meeting of the American Academy of Orthopaedic Surgeons (AAOS). This is the first report that shows the important link between low vitamin D levels and the severity of fractures in children caused by low-energy, less traumatic events such as falling off a bike or falling while running.

Fractures in children are very common, with some estimates as high as 50 percent of boys and 40 percent of girls having at least one fracture by age 18. Of these , the forearm is the most common site, accounting for approximately 25 percent of all pediatric fractures in the U.S.

"Not only are forearm fractures common in children, but so is vitamin D deficiency and insufficiency," said Pooya Hosseinzadeh, MD, assistant professor, Department of Orthopaedic Surgery at Washington University School of Medicine in St. Louis. "Knowing that vitamin D deficiency can lead to negative calcium balance, low bone mineral density and quality leading to compromised bone strength, it makes sense for patients to be more susceptible to fractures at lower impact load and more susceptible to greater severity when fractures do occur."

In this study, 100 children (ages 3 to 15; 65 percent male, 35 percent female) with low-energy forearm fractures were prospectively enrolled. Each participant filled out a questionnaire focusing on risk factors for vitamin D deficiency. The mean 25-hydroxyvitamin D (25[OH]D) concentration was 27.5 + 8.3 ng/ml.

The fractures were then categorized as requiring non-operative or operative management. The children's vitamin D status was based on measurement of 25(OH)D concentration obtained during the clinic visit, and was compared between the two fracture groups.

Among the results of the study:

  • Using Endocrine Society guidelines, 21 percent of patients were vitamin D deficient (25(OH)D < 20 ng/ml) and 49 percent had vitamin D insufficiency (25(OH)D: 21 - 29 ng/ml).
  • There was a dramatic difference in incidence rates of vitamin D deficiency between those treated surgically (50 percent) compared to those in the non-operative group (17 percent).
  • Being vitamin D deficient was also associated with a greater risk of needing operative management (28.6 percent versus 7.6 percent non-operative).
  • Being overweight/obese and nonwhite increased the likelihood of vitamin D deficiency.
  • Seventy-five percent of children in the operative group were obese or overweight, compared to only 32 percent of children in the non-operative group.
  • Patients requiring operative management were older than 10 years of age and had greater BMI than patients not requiring surgery.

"This study provides an important takeaway for parents and pediatricians." explains Dr. Hosseinzadeh. "If a child does have a forearm fracture, we would encourage the physician to check the patient's vitamin D levels. The good news is that in most cases, can reduce deficiency with a D supplement and increasing outdoor activity."

Explore further: 44 percent of postmenopausal women with distal radius fracture have low levels of vitamin D

Related Stories

44 percent of postmenopausal women with distal radius fracture have low levels of vitamin D

February 7, 2012
Wrist fractures, also called distal radius fractures (DRF), are among the most common osteoporosis-related fractures occurring on average 15 years earlier than hip fractures. As vitamin D deficiency has recently been linked ...

Calcium, vitamin D don't seem to reduce fracture risk in seniors

December 27, 2017
(HealthDay)—For community-dwelling older adults, supplementation with calcium, vitamin D, or both does not reduce the incidence of fractures, according to a review published in the Dec. 26 issue of the Journal of the American ...

Poorer bone health seen in black children with fractures

August 27, 2012
(HealthDay)—African-American children with forearm fractures are more likely to have vitamin D deficiency and lower bone mineral density than their peers without fractures, according to a study published online Aug. 27 ...

Vitamin D deficiency high among trauma patients

February 7, 2012
New research presented at the 2012 Annual Meeting of the American Academy of Orthopaedic Surgeons (AAOS) found that 77 percent of trauma patients had deficient or insufficient levels of vitamin D.

Potential new target for reducing osteoporosis risk in men

January 31, 2018
Researchers have identified a new regulator of vitamin D metabolism that could be targeted to reduce the risk of osteoporosis in men undergoing prostate cancer therapy, according to a study published in the Journal of Molecular ...

Living in a sunny climate does not improve vitamin D levels in hip fracture patients

March 19, 2013
While it is well known that a majority of hip fracture patients of all ages and both sexes have insufficient or deficient levels of vitamin D, a new study presented today at the 2013 Annual Meeting of the American Academy ...

Recommended for you

Surgeon performance benefits from 'warm-up'

March 20, 2018
Surgeons progressively 'warm-up' as they repeat a procedure on their operating list, akin to the way athletes' performance improves across a competition—according to new research.

Blood stored longer may be less safe for patients with massive blood loss and shock

March 10, 2018
Human blood from donors can be stored for use up to 42 days, and it is a mainstay therapy in transfusion medicine. However, recent studies looking back at patient records have shown that transfusion with older, stored blood ...

After knee replacement, play on

March 8, 2018
(HealthDay)—Knee replacement patients can continue to enjoy sports—such as skiing, tennis and dancing—without worrying that high-impact activities might compromise their new joint, a small, new study finds.

Engineered cartilage template to heal broken bones

March 8, 2018
A team of UConn Health researchers has designed a novel, hybrid hydrogel system to help address some of the challenges in repairing bone in the event of injury. The UConn Health team, led by associate professor of orthopedic ...

Treating hypothyroidism to stop a stubborn surgical complication

March 7, 2018
Researchers at the University of Michigan have discovered a link between low thyroid hormone levels and wound healing complications.

Neurocognitive impairment linked to worse outcomes after total joint replacement

March 6, 2018
People with undiagnosed neurocognitive deficits are undergoing hip and knee replacements at high rates and are more likely to have poorer short-term outcomes after surgery, according to new research led by orthopedic surgeons ...


Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.